Atriofascicular pathways
Raja Selvaraj
Cardiac Electrophysiologist
Professor of Cardiology
JIPMER
Terminology
Mahaim fiber
Mahaim tachycardia
Atriofascicular pathway
Antidromic tachycardia
Clinical presentation - Tachycardia
Atriofascicular AP - Classical features
No retrograde conduction through pathway
Antegrade conduction is decremental
Variable preexcitation from different atrial sites
Retrograde His activation with short, fixed VH
Tachycardia
AOP during tachycardia
Septal refractory PAC preexcites V
Septal refractory PAC - Other responses
Can postpone next V
Can terminate tachycardia
Ventricular overdrive pacing
Mapping
Pathway potential
Ablation
Automaticity
Automaticity and echo
Difficult cases
Multipolar catheter along TA ?
Map on ventricular side of annulus
Parallel versus Perpendicular orientation of map catheter
More ventricular
Bump
ECG - What is seen ?
ECG - What is seen ?