Abstract
Mahaim (M) accessory pathway (AP) is an endocardia atrioventricular (AV) node-like structures that connect the atrium to the ventricle. M fibers were first described as accessory connections taking off from the fascicular system to the right ventricle called fasciculoventricular (FV) or from the AV node to the right ventricle called nodoventricular fibers (NV) or connecting the AV node to the fascicles called nodo-fascicular (NF). However, the majority, if not all, of Mahaim AP are atriofascicular connecting the atrium to the fasicular system. We describe two cases with non-WPW accessory pathways and their successful ablation along with a literature review.
Highlights
The objective of this review article is to describe the electro physiologic features, diagnosis and treatment of Mahaim accessory pathway
M fibers were first described as accessory connections taking off from the fascicular system to the right ventricle called fasciculoventricular (FV) or from the AV node to the right ventricle called nodoventricular fibers (NV) or connecting the AV node to the fascicles called nodofascicular (NF)
More recent observations [1,2,3,4] have suggested that the majority, if not all, of Mahaim accessory pathway (AP) are atriofascicular connecting the atrium to the fascicular system
Summary
The objective of this review article is to describe the electro physiologic features, diagnosis and treatment of Mahaim accessory pathway. An important observation was made in 1978 by Becker et al [8] who found an accessory node associated with a bundle of specialized fibers measuring 1 cm and coursing through the right ventricle, mimicking a second AV conduction system located on the lateral tricuspid annulus.
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