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Indian Pacing Electrophysiol J. 2018 Jul - Aug;18(4):146-147. doi: 10.1016/j.ipej.2018.01.004. Epub 2018 Jan 31.

Persistent ventricular preexcitation despite right bundle branch block.

Indian pacing and electrophysiology journal

Taihei Itoh, Takumi Yamada

Affiliations

  1. Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
  2. Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: [email protected].

PMID: 29407483 PMCID: PMC6090072 DOI: 10.1016/j.ipej.2018.01.004

Abstract

A 44-year-old man with a history of ventricular preexcitation and supraventricular tachycardia was evaluated. The baseline electrocardiogram exhibited ventricular preexcitation with a normal PR interval and a minimally negative delta wave in lead V1 and positive delta waves in the inferior leads. The administration of adenosine resulted in a progressive prolongation of the PR interval with a fixed preexcitation degree, suggesting the presence of antegrade conduction over the fasciculo-ventricular pathway. When complete right bundle branch block occurred, the degree of preexcitation never changed. These findings suggested that the fasciculo-ventricular pathway was likely to be connected to the left-sided His-Purkinje system.

Copyright © 2018 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

Keywords: Bundle branch block; Fasciculoventricular pathway; Mahaim fiber; Preexcitation

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