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首页> 外文期刊>Indian Pacing and Electrophysiology Journal >Looks Like VT But Isn't - Successful Ablation Of A Left Free Wall Accessory Pathway With Mahaim-like Properties
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Looks Like VT But Isn't - Successful Ablation Of A Left Free Wall Accessory Pathway With Mahaim-like Properties

机译：看起来像VT，但不是-具有Mahaim类特性的左自由墙附件通路的成功消融

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It was long believed that Mahaim pathways represented nodo-fascicular or nodo-ventricular connections. However, this misconception was challenged when patients underwent surgical or catheter ablation of the AV node but remained pre-excited. Electrophysiology (EP) studies showed these pathways to be right sided decrementally conducting atrio-fascicular accessory pathways with the atrium forming a part of the antidromic tachycardia circuit. Mahaim pathways are usually reported to occur on the right side. We report a patient who presented with a broad complex tachycardia thought to be ventricular tachycardia; however during EP study this was shown to be an antidromic atrioventricular tachycardia utilising a left free wall pathway that demonstrated 'Mahaim-like' properties and was successfully ablated. The pathway was shown to have long conduction times with no retrograde conduction, had an effective refractory period longer than the AV node and its conduction was only evident during antidromic AVRT. It also had a decremental antegrade property and was responsive to intravenous adenosine. These 'Mahaim-like' features are very unusual and rarely reported on the left side.
机译：长期以来人们一直认为，Mahaim通路代表结节束或结节室连接。但是，当患者接受外科手术或导管消融房室结但仍处于预激状态时，这种误解就受到了挑战。电生理学（EP）研究表明，这些途径在右侧递减地进行房室束状辅助途径，而心房形成了抗心动过速回路的一部分。据报道，Mahaim途径通常发生在右侧。我们报告了一名患者，其表现为广泛的复杂性心动过速，认为是室性心动过速。然而，在EP研究中，这被证明是一种抗左房室性心动过速，利用左自由壁途径表现出“ Mahaim样”特性并被成功消融。显示该途径具有长的传导时间，没有逆行传导，其有效不应期长于AV节点，并且其传导仅在抗病性AVRT期间可见。它也具有递减的顺性，并且对静脉内腺苷有反应。这些“ Mahaim式”功能非常不常见，很少在左侧报告。

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