Coexistent Mahaim and Kent accessory connections: diagnostic and therapeutic implications.

Abstract:

:Six patients with coexistent Mahaim and Kent accessory connections are described. Two had left nodoventricular Mahaim connections, the first reported cases demonstrating these findings. In neither were the left-sided Mahaim connections components of a tachycardia and their presence was incidental. In two of four with nodoventricular connections, associated atrioventricular (AV) node conduction and coexistent posteroseptal accessory pathways were found. One of these had the unusual finding of a right-sided Mahaim connection arising from a "fast" AV node pathway. In only one patient did the tachycardia incorporate the Mahaim connection. In this patient, anterograde conduction during tachycardia occurred over a right nodoventricular connection whereas retrograde conduction occurred through a concealed right free wall Kent connection. Two patients had fasciculoventricular connections that were associated with either septal (one patient) or left free wall (one patient) Kent connections. The latter also had evidence of enhanced AV node conduction. This report is unique in that it describes in detail two patients with left nodoventricular connections (Mahaim) inserting in or near the left posterior fascicle. Combined Kent and Mahaim connections, present in the six patients, appear to occur in approximately 5% of patients with the Wolff-Parkinson-White syndrome. Precise identification of bypass connections critical for reentrant circuits is essential for intelligent application of treatment options.

journal_name

J Am Coll Cardiol

authors

Abbott JA,Scheinman MM,Morady F,Shen EN,Miller R,Ruder MA,Eldar M,Seger JJ,Davis JC,Griffin JC

doi

10.1016/s0735-1097(87)80020-7

subject

Has Abstract,Author List Incomplete

pub_date

1987-08-01 00:00:00

pages

364-72

issue

2

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(87)80020-7

journal_volume

10

pub_type

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