Ozcan EE, Turan OE, Akdemir B, Inevi UD, Yilancioglu RY, Baskurt AA, Alak C, Bayrak F. Comparison of electrophysiological characteristics of right- and left-sided Mahaim-type accessory pathways.
J Cardiovasc Electrophysiol 2021;
32:360-369. [PMID:
33355963 DOI:
10.1111/jce.14852]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/26/2020] [Accepted: 12/13/2020] [Indexed: 12/01/2022]
Abstract
AIMS
Mahaim-type accessory pathways (MAPs) are generally right-sided due to the embryological differentiation, but left-sided localization is also possible. This study aims to compare the clinical and electrophysiological characteristics of right- and left-sided MAPs.
METHODS
Of 251 patients diagnosed with AP by electrophysiological study between November 2015 and February 2020, 12 patients with MAP were included (right sided n = 8, left sided n = 4). MAP was diagnosed if; (1) no retrograde conduction; (2) anterograde decremental conduction; (3) adenosine sensitivity; and (4) Mahaim potential at successful ablation site were present.
RESULTS
Ten of twelve MAPs were clustered on the lateral walls of the mitral (n = 3, 75%) and tricuspid annuli (n = 7, 87.5%). Right-sided MAPs were mostly long pathways extending toward the conduction system whereas left-sided MAPs were short extending toward the neighboring myocardium. For right- and left-sided APs, the median QRS times were 129 and 156 ms (p = .042), the median VAbl -RVApex intervals were -12 and 64 ms (p = .007), the median QRS-V(His) intervals were 16 and 86 ms (p = .120), and the median VAbl -QRS interval was -8 and 12 ms (p = .017), respectively. Coexistence of dual atrioventricular node physiology was observed only in right-sided APs (n = 3, 37.5%).
CONCLUSION
MAPs are more typically located on the right but may rarely be seen on the left. Catheter ablation was associated with high success without complications.
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