"Nodoventricular" accessory pathway: evidence for a distinct accessory atrioventricular pathway with atrioventricular node-like properties

J Am Coll Cardiol. 1988 May;11(5):1035-40. doi: 10.1016/s0735-1097(98)90063-8.

Abstract

Two patients are described with recurrent pre-excited tachycardia and electrophysiologic characteristics typically ascribed to a nodoventricular accessory connection. The accessory pathway in each case demonstrated rate-dependent prolongation of conduction time and a low right ventricular insertion site; it was associated with a left bundle branch block configuration during pre-excitation. Intraoperatively, the pathway was demonstrated to originate at the anterior right atrioventricular (AV) anulus and not at the AV node. These data suggest that a "typical" nodoventricular pathway, by electrophysiologic criteria, may in fact be an AV pathway with AV node-like conduction properties and a distal right ventricular insertion site.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrioventricular Node / physiopathology*
  • Bundle-Branch Block / physiopathology
  • Electrocardiography
  • Electrophysiology
  • Female
  • Heart Conduction System / physiopathology*
  • Heart Ventricles / innervation
  • Humans
  • Intraoperative Care
  • Male
  • Pre-Excitation Syndromes / physiopathology*
  • Pre-Excitation, Mahaim-Type / physiopathology*
  • Pre-Excitation, Mahaim-Type / surgery
  • Recurrence
  • Tachycardia / physiopathology*
  • Tachycardia / surgery
  • Tachycardia, Supraventricular / physiopathology
  • Tachycardia, Supraventricular / surgery