Accessory atrioventricular node with properties of a typical accessory pathway: anatomic-electrophysiologic correlation. 2000

M H Gollob, and S Bharati, and C D Swerdlow
Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas 77030, USA. mgollob@bcm.tmc.edu

We report an accessory AV node producing ventricular preexcitation and comprising the retrograde limb of AV reentrant tachycardia (AVRT). A 66-year-old man presented with an anteroseptal myocardial infarction and thereafter developed recurrent, drug-refractory AVRT requiring multiple cardioversions. Electrophysiologic findings were typical for a concealed anteroseptal accessory pathway 0.5 cm anterior to the His bundle. The patient died of intractable heart failure after endocardial resection for a left ventricular aneurysm and coronary bypass grafting. Pathologic examination revealed a para-Hisian accessory AV node connecting the right atrium to ventricular myocardium immediately anterior to the His bundle at a depth of 4 mm from the endocardium. No typical AV accessory pathway was found. This is the first report of an accessory AV node that participated in AVRT. It was deeper than typical radiofrequency catheter ablation lesions.

UI MeSH Term Description Entries
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002303 Cardiac Output, Low A state of subnormal or depressed cardiac output at rest or during stress. It is a characteristic of CARDIOVASCULAR DISEASES, including congenital, valvular, rheumatic, hypertensive, coronary, and cardiomyopathic. The serious form of low cardiac output is characterized by marked reduction in STROKE VOLUME, and systemic vasoconstriction resulting in cold, pale, and sometimes cyanotic extremities. Low Cardiac Output,Low Cardiac Output Syndrome,Output, Low Cardiac
D004554 Electric Countershock An electrical current applied to the HEART to terminate a CARDIAC ARRHYTHMIA. Cardiac Electroversion,Cardioversion,Defibrillation, Electric,Electroversion, Cardiac,Electrical Cardioversion,Electroversion Therapy,Therapy, Electroversion,Cardiac Electroversions,Cardioversion, Electrical,Cardioversions,Cardioversions, Electrical,Countershock, Electric,Countershocks, Electric,Defibrillations, Electric,Electric Countershocks,Electric Defibrillation,Electric Defibrillations,Electrical Cardioversions,Electroversion Therapies,Electroversions, Cardiac,Therapies, Electroversion
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006322 Heart Aneurysm A localized bulging or dilatation in the muscle wall of a heart (MYOCARDIUM), usually in the LEFT VENTRICLE. Blood-filled aneurysms are dangerous because they may burst. Fibrous aneurysms interfere with the heart function through the loss of contractility. True aneurysm is bound by the vessel wall or cardiac wall. False aneurysms are HEMATOMA caused by myocardial rupture. Cardiac Aneurysm,Aneurysm, Cardiac,Aneurysm, Heart,Aneurysms, Cardiac,Aneurysms, Heart,Cardiac Aneurysms,Heart Aneurysms
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D001283 Atrioventricular Node A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. AV Node,A-V Node,Atrio-Ventricular Node,A V Node,A-V Nodes,AV Nodes,Atrio Ventricular Node,Atrio-Ventricular Nodes,Atrioventricular Nodes,Node, A-V,Node, AV,Node, Atrio-Ventricular,Node, Atrioventricular,Nodes, A-V,Nodes, AV,Nodes, Atrio-Ventricular,Nodes, Atrioventricular

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