Journal Article

Spontaneous automaticity of an atriofascicular accessory pathway

Santosh Kumar Dora, Jaganmohan A. Tharakan, Ajithkumar Valaparambil, Narayanan Namboodiri, Krishnakumar Nair and Thomas Peter

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 8, issue 2, pages 140-143
Published in print February 2006 | ISSN: 1099-5129
Published online January 2006 | e-ISSN: 1532-2092 | DOI:
Spontaneous automaticity of an atriofascicular accessory pathway

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In a 12-year-old girl with history of recurrent palpitation, an ambulatory 24 h Holter electrocardiogram showed a wide QRS complex rhythm with atrioventricular dissociation. During an electrophysiology study, an atriofascicular pathway was diagnosed with an inducible antidromic atrioventricular re-entrant tachycardia. At slower heart rates, the patient had a wide QRS complex escape rhythm similar to the tachycardia and the pre-excited QRS complex morphology. This indicates the presence of pacemaker-like cells in the atriofascicular accessory pathway giving rise to the wide QRS complex escape rhythm at a slower heart rate.

Keywords: Accessory pathway; Automaticity; Mahaim fibre; Atriofascicular pathway

Journal Article.  1293 words.  Illustrated.

Subjects: Cardiovascular Medicine

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