Is the activation potential of Mahaim pathway always a fast potential? Implication for radiofrequency catheter ablation

Haghjoo, M. and Arya, A. and Emkanjoo, Z. and Sadr-Ameli, M.A. (2005) Is the activation potential of Mahaim pathway always a fast potential? Implication for radiofrequency catheter ablation. Europace, 7 (5). pp. 440-446.


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Introduction: Accessory pathways (AP) exhibiting Mahaim physiology are amenable to radiofrequency (RF) catheter ablation. The recording of an AP potential is an excellent guide for selection of ablation site. The purpose of this study is to determine whether the pathway potential is always a fast potential. Methods: Ten patients (six females, mean age, 30±12 years) with preexcited tachycardias involving a Mahaim pathway underwent electrophysiological study and subsequent attempts at RF ablation. Mahaim potentials (M-potential) recorded at the site of successful ablation were reviewed and classified by at least two reviewers. Results: In all patients, Mahaim pathways were characterized as atriofascicular types. The M-potential was fast in seven patients (group one), and slow in the remaining patients (group two). All group two patients had a history of prior failed ablation. Atrial electrograms were recorded closer to the QRS onset in group one. Atrium to fast M-potential (42±15 ms) was shorter than atrium to slow M-potential (83±12 ms, P=0.03) but M-potentials were recorded with similar distance before local ventricular electrogram (P=NS). Ablation was successful in all patients with mean of 2.9±1.4 RF applications per patient. Ablation data were similar between the two groups (P=NS). No complications occurred. During 12 months of follow-up, no recurrence was observed. Conclusion: Our results illustrated that the activation potential of Mahaim pathways is not always a fast potential. One-third of Mahaim pathways can be mapped and ablated when the slow type of M-potential was used as a target for ablation. We also confirmed high efficacy of catheter ablation of Mahaim pathways guided by activation potentials. © 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Item Type: Article
Additional Information: cited By 1
Uncontrolled Keywords: adolescent; adult; article; catheter ablation; clinical article; electrocardiogram; electrophysiology; female; heart accessory conduction pathway; heart muscle potential; heart preexcitation; human; Mahaim pathway; male; priority journal; QRS complex; treatment outcome, Adolescent; Adult; Catheter Ablation; Chi-Square Distribution; Electrophysiologic Techniques, Cardiac; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pre-Excitation, Mahaim-Type; Treatment Outcome
Subjects: WG Cardiovascular System
Depositing User: Librarian Farzaneh Dini
Date Deposited: 19 May 2019 06:52
Last Modified: 19 May 2019 06:52

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