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Hands On| Volume 12, ISSUE 7, P1677-1682, July 2015

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Nodo- and fasciculoventricular pathways: Electrophysiological features and a proposed diagnostic algorithm for preexcitation variants

Published:April 07, 2015DOI:https://doi.org/10.1016/j.hrthm.2015.04.009
Nodo- and fasciculoventricular pathways: Electrophysiological features and a proposed diagnostic algorithm for preexcitation variants
Previous ArticleDifferential diagnosis of regular, narrow-QRS tachycardias
Next ArticlePreclinical testing and optimization of a novel fetal micropacemaker
      Fasciculoventricular and nodoventricular pathways (FVP and NVP) are uncommon preexcitation variants that can be misleading during electrophysiology studies (EPSs), and differentiating them could be challenging.
      • Sternick E.B.
      • Gerken L.M.
      • Vrandecic M.O.
      • Wellens H.J.
      Fasciculoventricular pathways: clinical and electrophysiologic characteristics of a variant of preexcitation.
      J Cardiovasc Electrophysiol. 2003; 14: 1057-1063
      , 
      • Lau E.W.
      Infraatrial supraventricular tachycardias: mechanisms, diagnosis, and management.
      Pacing Clin Electrophysiol. 2008; 31: 490-498
      , 
      • Hoffmayer K.S.
      • Lee B.K.
      • Vedantham V.
      • Bhimani A.A.
      • Cakulev I.T.
      • Mackall J.A.
      • Sahadevan J.
      • Rho R.W.
      • Scheinman M.M.
      Variable clinical features and ablation of manifest nodofascicular/ventricular pathways.
      Circ Arrhythm Electrophysiol. 2015; 8: 117-127
      In this article, we describe 2 representative cases and then we present various electrophysiological features and phenomenon encountered in patients with these particular accessory pathways (APs).

      Abbreviations:

      AP (accessory pathway), AV (atrioventricular), EPS (electrophysiology study), FVP (fasciculoventricular pathway), HB (His bundle), NVP (nodoventricular pathway), PAS (programmed atrial stimulation), RBBB (right bundle branch block)

      Keywords

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      References

        • Sternick E.B.
        • Gerken L.M.
        • Vrandecic M.O.
        • Wellens H.J.
        Fasciculoventricular pathways: clinical and electrophysiologic characteristics of a variant of preexcitation.
        J Cardiovasc Electrophysiol. 2003; 14: 1057-1063
        View in Article
        • Lau E.W.
        Infraatrial supraventricular tachycardias: mechanisms, diagnosis, and management.
        Pacing Clin Electrophysiol. 2008; 31: 490-498
        View in Article
        • Hoffmayer K.S.
        • Lee B.K.
        • Vedantham V.
        • Bhimani A.A.
        • Cakulev I.T.
        • Mackall J.A.
        • Sahadevan J.
        • Rho R.W.
        • Scheinman M.M.
        Variable clinical features and ablation of manifest nodofascicular/ventricular pathways.
        Circ Arrhythm Electrophysiol. 2015; 8: 117-127
        View in Article
        • Tchou P.
        • Lehmann M.H.
        • Jazayeri M.
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        Atriofascicular connection or a nodoventricular Mahaim fiber? Electrophysiologic elucidation of the pathway and associated reentrant circuit.
        Circulation. 1988; 77: 837-848
        View in Article
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        Accurate evaluation of para-Hisian pacing in a patient with fasciculoventricular bypass.
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        Clinical, electrocardiographic, and electrophysiologic characteristics of patients with a fasciculoventricular pathway: the role of PRKAG2 mutation.
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        • Veenhuyzen G.D.
        Entrainment mapping of a concealed nodoventricular accessory pathway in a man with complete heart block and tachycardia-induced cardiomyopathy.
        J Cardiovasc Electrophysiol. 2008; 19: 90-94
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        Cryoablation of a nodoventricular Mahaim fiber.
        J Interv Card Electrophysiol. 2005; 14: 111-116
        View in Article

      Article info

      Publication history

      Published online: April 07, 2015

      Identification

      DOI: https://doi.org/10.1016/j.hrthm.2015.04.009

      Copyright

      © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

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