Comparison of electrophysiological characteristics of right- and left-sided Mahaim-type accessory pathways.

Autor: Ozcan EE; Department of Cardiology, Dokuz Eylul University School of Medicine, Izmir, Turkey., Turan OE; Department of Cardiology, Dokuz Eylul University School of Medicine, Izmir, Turkey., Akdemir B; Department of Cardiology, Faculty of Medicine, Goztepe Medicalpark Hospital, Bahcesehir University, Istanbul, Turkey., Inevi UD; Ege Aritmi Medical Products Engineering, İzmir, Turkey., Yilancioglu RY; Department of Cardiology, Dokuz Eylul University School of Medicine, Izmir, Turkey., Baskurt AA; Department of Cardiology, Dokuz Eylul University School of Medicine, Izmir, Turkey., Alak C; Department of Cardiology, Dokuz Eylul University School of Medicine, Izmir, Turkey., Bayrak F; Department of Cardiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2021 Feb; Vol. 32 (2), pp. 360-369. Date of Electronic Publication: 2021 Jan 09.
DOI: 10.1111/jce.14852
Abstrakt: 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 V Abl -RV Apex intervals were -12 and 64 ms (p = .007), the median QRS-V (His) intervals were 16 and 86 ms (p = .120), and the median V Abl -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.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
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