Atriofascicular Mahaim with Ebstein anomaly: A case report

We report a case of a 7-year-old girl with atriofascicular Mahaim (AFM) pathway concomitant with Ebstein's anomaly. The QRS wave showed left bundle branch block pattern on electrocardiogram. Holter electrocardiogram showed prolongation of the PR interval and QRS morphological change during sinus tachycardia. An electrophysiological study demonstrated that the distal His potential appeared earlier than the proximal His potential, which suggested retrograde His conduction toward the atrioventricular node. Conduction from the Mahaim fiber to the His bundle was faster than that from the atrioventricular node towards the His bundle. The findings of this important case allowed a differential diagnosis between AFM and Wolff-Parkinson-White (WPW) syndrome.
Source: Journal of Arrhythmia - Category: Cardiology Source Type: research

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ECG in Ebstein’s anomaly of tricuspid valve ECG in Ebstein’s anomaly of tricuspid valve ECG in Ebstein’s anomaly of tricuspid valve showing right axis deviation of QRS, notched R waves in II, III, aVF and V1 suggesting fragmented QRS. Peaked P waves indicate a right atrial abnormality, though the typical voltage criteria for right atrial enlargement (more than 0.25 mV) is not satisfied. Fragmented QRS occurs in Ebstein’s anomaly due to abnormal conduction in the atrialised right ventricle [1]. A portion of the right ventricle is atrialised because of distal displacement of the septal and posterior ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: ECG / Electrophysiology ECG Library fragmented QRS Source Type: blogs
Authors: Hanna Deschamps E, Hanna EB Abstract An atrioventricular accessory pathway (AP) may be manifest or concealed. When manifest, it leads to preexcitation on the baseline electrocardiogram, which is called the Wolff-Parkinson-White pattern. The degree of preexcitation varies according to the relative conduction speed of the atrioventricular node versus the AP, the AP location, and the AP refractory period. This explains that even a manifest AP may lead to only intermittent preexcitation. The AP conducts faster than the atrioventricular node but has a longer refractory period, which allows the initiation of a r...
Source: Southern Medical Journal - Category: Journals (General) Tags: South Med J Source Type: research
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 7. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rate...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Abstract BACKGROUND: Wolff-Parkinson-White syndrome is a congenital abnormality of the cardiac conduction system caused by the presence of an abnormal accessory electrical pathway between the atria and the ventricles. This can result in intermittent tachyarrhythmias such as supraventricular tachycardia. In rare occasions, sudden death may occur from atrial fibrillation with rapid ventricular conduction. Supraventricular tachycardia typically has a sudden onset and offset, classified as a paroxysmal arrhythmia. Because of the variable occurrence, Wolff-Parkinson-White syndrome may go undiagnosed in the immediate ne...
Source: Advances in Neonatal Care - Category: Nursing Authors: Tags: Adv Neonatal Care Source Type: research
Abstract Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. The condition is caused by reentry phenomena or automaticity at or above the atrioventricular node, and includes atrioventricular nodal reentrant tachycardia, atrioventricular reciprocating tachycardia, and atrial tachycardia. Most persons with these tachyarrhythmias have structurally normal hearts. Sudden onset of an accelerated heart rate can cause palpitations, light-headedness, chest discomfort, anxiety, dyspnea, or fatigue. The history is important t...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
A recently developed, ECG-based, three dimensional (3D) electrocardiomapping modality named Electrocardiographic Imaging (ECGI) has refined non-invasive diagnosis of heart rhythm disorders [1][2][3]. Our clinical experience in using this non-invasive mapping technique to identify the sources of electrical disorders and guide catheter ablation of atrial arrhythmias (premature atrial beat, atrial tachycardia, atrial fibrillation), ventricular arrhythmias (premature ventricular beats) and ventricular pre-excitation (Wolff-Parkinson-White syndrome) is described below.
Source: Journal of Electrocardiology - Category: Cardiology Authors: Source Type: research
Abstract Since more than 100 years, 12-lead electrocardiography (ECG) is the standard-of-care tool, which involves measuring electrical potentials from limited sites on the body surface to diagnose cardiac disorder, its possible mechanism, and the likely site of origin. Several decades of research has led to the development of a 252-lead ECG and computed tomography (CT) scan-based three-dimensional electro-imaging modality to non-invasively map abnormal cardiac rhythms including fibrillation. These maps provide guidance towards ablative therapy and thereby help advance the management of complex heart rhythm ...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
A 47-year-old asymptomatic male public driver with situs inversus totalis and Wolff-Parkinson-White electrocardiographic pattern (Fig. 1a) was referred to our arrhythmia center for electrophysiologic study. A decapolar coronary sinus catheter was introduced via the right femoral vein and positioned in the coronary sinus on the right anterior oblique projection. Intracardiac electrograms showed the earliest ventricular activation with a 25ms ventricular potential-delta interval and no isoelectric interval between atrial and ventricular potentials on the distal bipole of the catheter suggesting a lateral free wall accessory pathway.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the Editor Source Type: research
This study assessed the accuracy of the new 2014 ‘Refined Criteria’ against the 2013 Seattle Criteria and the 2010 European Society of Cardiology (ESC) recommendations in a cohort of Arabic, black and Caucasian athletes. Methods 2491 male athletes (1367 Arabic, 748 black and 376 Caucasian) undertook pre-participation screening including a 12-lead ECG, with further investigation(s) upon indication. Results Ten athletes (0.4%) were identified with cardiac pathology; seven with hypertrophic cardiomyopathy (HCM; five black and two Arabic) and three Arabs with Wolff–Parkinson–White syndrome (WPW). All ...
Source: Heart - Category: Cardiology Authors: Tags: Open access, Hypertrophic cardiomyopathy, Drugs: cardiovascular system, Pacing and electrophysiology, Epidemiology Arrhythmias and sudden death Source Type: research
A 31-year-old man presented to the ED with syncope. He was previously healthy, takes no medications, and had run a marathon the day before. He was riding the light rail home from a baseball game when he developed vague 4/10 epigastric abdominal pain associated with nausea and diaphoresis. He remembers feeling lightheaded and flushed before momentarily passing out. His wife said he became quite pale immediately beforehand. He did not have any headache, chest pain, or shortness of breath before or after the syncopal episode. He has a significant family history of premature coronary artery disease. He had normal vital s...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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