Author + information
- Received August 24, 1987
- Revision received September 17, 1987
- Accepted December 22, 1987
- Published online May 1, 1988.
- George J Klein, MD, FRCP(C), FACC∗,a,
- Gerard M Guiraudon, MD, FRCS(C), FACCa,
- Charles R Kerr, MD, FRCP(C), FACCa,∗,
- Arjun D Sharma, MD, FRCP (C), FACCa,
- Raymond Yee, MD, FRCP(C)a,
- Tibor Szabo, MDa and
- John A.Yeung Lai Wah, MB, ChB, FRCP(C)a,∗
- ↵∗Address for reprints: George J. Klein, MD, University Hospital, 339 Windermere Road, London, Ontario, Canada N6A 5A5.
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.
☆ This study was supported by the Ontario Heart Foundation, Toronto, and the British Columbia Heart Foundation, Vancouver.
- Received August 24, 1987.
- Revision received September 17, 1987.
- Accepted December 22, 1987.