Abstract
This report concerns pathologic findings in a 54 year old woman with intermittent preexcitation who died of carcinoma of the breast. Electrocardiograms revealed predominantly normal sinus rhythm with a normal P-R interval and narrow QRS complex. Episodes of sinus rhythm, short P-R interval and QRS widening (with delta wave) were also recorded. During preexcitation QS complexes were noted in leads II, III, aVF, V1 and V4 to V6. Delta waves were negative in leads II, III, aVF and V1 isoelectric in leads V4 to V6 and positive only in leads I, aVL, V2 and V3. This case thus defies classification into any known variety of preexcitation. Complete serial sections, cut through the entire conduction system and both atrioventricular (A-V) rims, totaled 18,600 sections. These revealed no bundle of Kent. Instead, Mahaim fibers histologically identified as His bundle tissue gave off from the A-V bundle to both the right and the left sides of the septum associated with the normal fibers of James. This case reveals that (1) fibers of James can bypass the A-V node, (2) fibers of Mahaim can conduct, and (3) there are types of preexcitation in addition to types A and B.
References
Jul 1, 1973·The American Journal of Cardiology·J P BoineauW C Sealy
Dec 1, 1974·Circulation·T N James, P Puech
Dec 1, 1972·British Heart Journal·A A Lunel
May 1, 1973·British Heart Journal·R H AndersonR S Jones
Feb 1, 1974·Circulation·A G WallaceJ Kasell
Mar 1, 1970·Circulation·J P Boineau, E N Moore
Jun 1, 1970·The American Journal of Cardiology·D DurrerH J Wellens
Nov 1, 1966·Circulation·M LevA Pick
Jan 1, 1954·Journal of Gerontology·M LEV
Jul 1, 1961·Circulation·M LEVQ H DE MESQUITA
Aug 1, 1960·The Anatomical Record·R C TRUEXD F DOWNING
Sep 1, 1963·American Heart Journal·M LEVC FRIEDLAND
May 1, 1955·American Heart Journal·M LEVR A MILLER
Jan 1, 1952·Journal of Gerontology·E E ERICKSON, M LEV
Aug 1, 1947·Annals of Internal Medicine·J L KIMBALL, G BURCH
Citations
Mar 15, 1989·Journal of the American College of Cardiology·N SchechtmannJ Abbott
Oct 18, 2001·The Journal of Emergency Medicine·D F Brown, E S Nadel
Jul 1, 1995·Pacing and Clinical Electrophysiology : PACE·J BrugadaF Navarro-López
Oct 1, 1995·Journal of Cardiovascular Electrophysiology·S BharatiM Josephson
Jul 1, 1978·British Heart Journal·P TouboulM T Chatelain
Aug 1, 1978·British Heart Journal·H MatsuguchiM Nakamura
Jan 1, 1981·British Heart Journal·R H AndersonM J Janse
Jul 1, 1984·British Heart Journal·T N James
Mar 1, 1995·British Heart Journal·S C HealdE Rowland
Oct 1, 1996·Journal of Cardiovascular Electrophysiology·H KottkampG Breithardt
Dec 9, 2008·Journal of Electrocardiology·Philippe ChevalierElodie Morel
Aug 3, 2007·Journal of Electrocardiology·Yun-Shik ChoiSeil Oh
Jan 5, 2007·Pacing and Clinical Electrophysiology : PACE·Mohammad V JoratMohammad A Sadr-Ameli
Apr 29, 2006·Journal of Cardiovascular Electrophysiology·David G Benditt, Fei Lü
Nov 15, 2006·Pacing and Clinical Electrophysiology : PACE·Snehal KothariRanjan K Thakur
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Eduardo Back SternickHein J J Wellens
Oct 1, 1981·The American Journal of Cardiology·F MoleiroR J Myerburg
Jul 1, 1977·American Heart Journal·P ProbstF Kaindl
Nov 4, 1976·The American Journal of Cardiology·A CastellanosS Bharati
Jun 30, 2001·Progress in Cardiovascular Diseases·T N James
Oct 1, 1976·Circulation·J J GallagherA G Wallace
Jul 1, 1994·Circulation·R CappatoK H Kuck
Jul 1, 1994·Circulation·G J KleinR Yee
Mar 1, 1993·Circulation·L S KleinW M Miles
Mar 1, 1979·Circulation·S BharatiK M Rosen
Feb 1, 1977·Circulation·C BrechenmacherT N James
Aug 1, 1990·Circulation·M HaissaguerreJ P Massiere
May 1, 1978·Circulation·A E BeckerH J Wellens
Jul 1, 1981·Circulation·J J GallagherA O Grant
May 1, 1983·Pacing and Clinical Electrophysiology : PACE·D G BendittD W Benson