Electrophysiology study and radiofrequency catheter ablation of atriofascicular tracts with decremental properties (Mahaim fibre) at the tricuspid annulus
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Date
2008
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EUROPACE
Abstract
Aims The aim was to study the common mapping methods for Mahaim fibre and their role in radiofrequency ( RF) ablation.Methods and results Fifteen patients having Mahaim fibre tachycardia underwent electrophysiological study. Mahaim fibre mapping methods like (i) Mahaim potential ( M), (ii) shortest atrial stimulus-to-preexcitation (STP), and (iii) mechanical trauma induced loss of conduction were studied. Accessory pathway mapping was performed by M potential in 10 patients (67%), shortest atrial STP in 3 patients (20%), and mechanical trauma in 2 patients (13%). Mahaim fibre was localized at right atrial freewall of tricuspid annulus (8-10 o'clock) in 13 patients (87%), at 6.30 o'clock in one patient, and at 5 o'clock in 1 patient. Fourteen patients underwent RF ablation. Thirteen patients had complete loss of conduction over accessory pathway and one had partial modi. cation with a conduction delay. Radiofrequency ablation was not performed in one patient ( shortest STP group) due to its closeness to the compact atrioventricular node. Mahaim junctional acceleration during RF ablation was observed in all patients of M potential, 1 patient of mechanical trauma, and none of the atrial STP group. One patient ( M potential group) had tachycardia recurrence during follow-up.Conclusion Mahaim fibre is commonly located between 8 and 10 o'clock at tricuspid annulus. M potential guides to successful RF ablation in most patients. Mahaim junctional acceleration is commonly seen during RF ablation guided by M potential map.
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Cardiology
Citation
EUROPACE. 10; 12; 1428-1433