"Nodoventricular" accessory pathway: evidence for a distinct accessory atrioventricular pathway with atrioventricular node-like properties

Department of Medicine, University of Western Ontario, London, Canada.

Two patients are described with recurrent pre-excited tachycardia and electrophysiologic characteristics typically ascribed to a nodoventricular accessory connection. The accessory pathway in each case demonstrated rate-dependent prolongation of conduction time and a low right ventricular insertion site; it was associated with a left bundle branch block configuration during pre-excitation. Intraoperatively, the pathway was demonstrated to originate at the anterior right atrioventricular (AV) anulus and not at the AV node. These data suggest that a "typical" nodoventricular pathway, by electrophysiologic criteria, may in fact be an AV pathway with AV node-like conduction properties and a distal right ventricular insertion site.

This article has been cited by other articles:

				E. Sosa and M. Scanavacca Incessant ventricular tachycardia due to spontaneous automaticity in the Purkinje network inducing reversible left ventricular dysfunction Europace, February 1, 2011; 13(2): 292 - 294. [Abstract] [Full Text] [PDF]

				V. M. Christoffels, G. J. Smits, A. Kispert, and A. F. M. Moorman Development of the Pacemaker Tissues of the Heart Circ. Res., February 5, 2010; 106(2): 240 - 254. [Abstract] [Full Text] [PDF]

				V. M. Christoffels and A. F.M. Moorman Development of the Cardiac Conduction System: Why Are Some Regions of the Heart More Arrhythmogenic Than Others? Circ Arrhythm Electrophysiol, April 1, 2009; 2(2): 195 - 207. [Full Text] [PDF]

				S. Bohora, S. K. Dora, N. Namboodiri, A. Valaparambil, and J. Tharakan Electrophysiology study and radiofrequency catheter ablation of atriofascicular tracts with decremental properties (Mahaim fibre) at the tricuspid annulus Europace, December 1, 2008; 10(12): 1428 - 1433. [Abstract] [Full Text] [PDF]

				I. Nault, F. Sacher, S. Knecht, M. Wright, N. Lellouche, S. Matsuo, K. J. Makati, M. Hocini, P. Jais, and M. Haissaguerre Wide complex tachycardia in a healthy young man Europace, November 1, 2008; 10(11): 1340 - 1342. [Abstract] [Full Text] [PDF]

				S. Hanon, M. Shapiro, and P. Schweitzer Early history of the pre-excitation syndrome Europace, January 1, 2005; 7(1): 28 - 33. [Abstract] [Full Text] [PDF]

				M. Haghjoo, A. Arya, Z. Emkanjoo, and M. A. Sadr-Ameli Is the activation potential of Mahaim pathway always a fast potential? Implication for radiofrequency catheter ablation Europace, January 1, 2005; 7(5): 440 - 446. [Abstract] [Full Text] [PDF]

				E. B. Sternick, C. Timmermans, E. Sosa, F. E.S. Cruz, L.-M. Rodriguez, M. Fagundes, L. M. Gerken, and H. J.J. Wellens The electrocardiogram during sinus rhythm and tachycardia in patients with Mahaim fibers: The importance of an "rS" pattern in lead III J. Am. Coll. Cardiol., October 19, 2004; 44(8): 1626 - 1635. [Abstract] [Full Text] [PDF]

				M. Haissaguerre, B. Cauchemez, F. Marcus, P. Le Metayer, P. Lauribe, F. Poquet, L. Gencel, and J. Clementy Characteristics of the Ventricular Insertion Sites of Accessory Pathways With Anterograde Decremental Conduction Properties Circulation, February 15, 1995; 91(4): 1077 - 1085. [Abstract] [Full Text]

				G. M. Guiraudon Surgical treatment of Wolff-Parkinson-White syndrome: A "retrospectroscopic" view Ann. Thorac. Surg., October 1, 1994; 58(4): 1254 - 1261. [Abstract] [PDF]

				G. M. Guiraudon, C. M. Guiraudon, G. J. Klein, R. Yee, and R. K. Thakur Operation for the Wolff-Parkinson-White syndrome in the Catheter ablation era Ann. Thorac. Surg., May 1, 1994; 57(5): 1084 - 1088. [Abstract] [PDF]

				G. M. Guiraudon, G. J. Klein, A. D. Sharma, R. Yee, R. R. Kaushik, and O. Fujimura Skeletonization of the atrioventricular node for AV node reentrant tachycardia: Experience with 32 patients Ann. Thorac. Surg., April 1, 1990; 49(4): 565 - 573. [Abstract] [PDF]