Surface electrocardiographic clues suggesting presence of a nodofascicular Mahaim fiber

G. H. Bardy, J. M. Fedor, L. D. German, Douglas L Packer, J. J. Gallagher

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Standard electrocardiograms from 87 consecutive patients with tachycardia of left bundle branch block configuration were analyzed retrospectively for features that might be characteristic of tachycardia utilizing a nodofascicular Mahaim fiber. The study group consisted of 13 patients with nodofascicular tachycardia, 34 with supraventricular tachycardia and aberrant conduction over the His-Purkinje system, 22 with ventricular tachycardia and 18 with antidromic tachycardia utilizing a right-sided accessory atrioventricular pathway. Six variables present during tachycardia of left bundle branch block configuration were predictive of a nodofascicular fiber: cycle length between 220 and 450 ms, QRS axis of 0 to -75°, QRS duration 0.15 second or less, R wave in lead I, rS wave in precordial lead V1 and a precordial transition from a negative to a positive QRS complex after lead V4. All six criteria were present in 16 of the 87 patients. No patient with ventricular tachycardia satisfied these criteria, whereas 3 of 34 with supraventricular tachycardia, 1 of 18 with antidromic tachycardia and 12 of 13 with tachycardia using a nodofascicular fiber did. It is concluded that analysis of the surface electrocardiogram during tachycardia may suggest the presence of a nodofascicular fiber.

Original languageEnglish (US)
Pages (from-to)1161-1168
Number of pages8
JournalJournal of the American College of Cardiology
Volume3
Issue number5
DOIs
StatePublished - 1984
Externally publishedYes

Fingerprint

Accessory Atrioventricular Bundle
Tachycardia
Supraventricular Tachycardia
Bundle-Branch Block
Ventricular Tachycardia
Electrocardiography

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Surface electrocardiographic clues suggesting presence of a nodofascicular Mahaim fiber. / Bardy, G. H.; Fedor, J. M.; German, L. D.; Packer, Douglas L; Gallagher, J. J.

In: Journal of the American College of Cardiology, Vol. 3, No. 5, 1984, p. 1161-1168.

Research output: Contribution to journalArticle

Bardy, G. H. ; Fedor, J. M. ; German, L. D. ; Packer, Douglas L ; Gallagher, J. J. / Surface electrocardiographic clues suggesting presence of a nodofascicular Mahaim fiber. In: Journal of the American College of Cardiology. 1984 ; Vol. 3, No. 5. pp. 1161-1168.
@article{5986553dbd9a4a7b82a4bbeead9077dc,
title = "Surface electrocardiographic clues suggesting presence of a nodofascicular Mahaim fiber",
abstract = "Standard electrocardiograms from 87 consecutive patients with tachycardia of left bundle branch block configuration were analyzed retrospectively for features that might be characteristic of tachycardia utilizing a nodofascicular Mahaim fiber. The study group consisted of 13 patients with nodofascicular tachycardia, 34 with supraventricular tachycardia and aberrant conduction over the His-Purkinje system, 22 with ventricular tachycardia and 18 with antidromic tachycardia utilizing a right-sided accessory atrioventricular pathway. Six variables present during tachycardia of left bundle branch block configuration were predictive of a nodofascicular fiber: cycle length between 220 and 450 ms, QRS axis of 0 to -75°, QRS duration 0.15 second or less, R wave in lead I, rS wave in precordial lead V1 and a precordial transition from a negative to a positive QRS complex after lead V4. All six criteria were present in 16 of the 87 patients. No patient with ventricular tachycardia satisfied these criteria, whereas 3 of 34 with supraventricular tachycardia, 1 of 18 with antidromic tachycardia and 12 of 13 with tachycardia using a nodofascicular fiber did. It is concluded that analysis of the surface electrocardiogram during tachycardia may suggest the presence of a nodofascicular fiber.",
author = "Bardy, {G. H.} and Fedor, {J. M.} and German, {L. D.} and Packer, {Douglas L} and Gallagher, {J. J.}",
year = "1984",
doi = "10.1016/S0735-1097(84)80173-4",
language = "English (US)",
volume = "3",
pages = "1161--1168",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Surface electrocardiographic clues suggesting presence of a nodofascicular Mahaim fiber

AU - Bardy, G. H.

AU - Fedor, J. M.

AU - German, L. D.

AU - Packer, Douglas L

AU - Gallagher, J. J.

PY - 1984

Y1 - 1984

N2 - Standard electrocardiograms from 87 consecutive patients with tachycardia of left bundle branch block configuration were analyzed retrospectively for features that might be characteristic of tachycardia utilizing a nodofascicular Mahaim fiber. The study group consisted of 13 patients with nodofascicular tachycardia, 34 with supraventricular tachycardia and aberrant conduction over the His-Purkinje system, 22 with ventricular tachycardia and 18 with antidromic tachycardia utilizing a right-sided accessory atrioventricular pathway. Six variables present during tachycardia of left bundle branch block configuration were predictive of a nodofascicular fiber: cycle length between 220 and 450 ms, QRS axis of 0 to -75°, QRS duration 0.15 second or less, R wave in lead I, rS wave in precordial lead V1 and a precordial transition from a negative to a positive QRS complex after lead V4. All six criteria were present in 16 of the 87 patients. No patient with ventricular tachycardia satisfied these criteria, whereas 3 of 34 with supraventricular tachycardia, 1 of 18 with antidromic tachycardia and 12 of 13 with tachycardia using a nodofascicular fiber did. It is concluded that analysis of the surface electrocardiogram during tachycardia may suggest the presence of a nodofascicular fiber.

AB - Standard electrocardiograms from 87 consecutive patients with tachycardia of left bundle branch block configuration were analyzed retrospectively for features that might be characteristic of tachycardia utilizing a nodofascicular Mahaim fiber. The study group consisted of 13 patients with nodofascicular tachycardia, 34 with supraventricular tachycardia and aberrant conduction over the His-Purkinje system, 22 with ventricular tachycardia and 18 with antidromic tachycardia utilizing a right-sided accessory atrioventricular pathway. Six variables present during tachycardia of left bundle branch block configuration were predictive of a nodofascicular fiber: cycle length between 220 and 450 ms, QRS axis of 0 to -75°, QRS duration 0.15 second or less, R wave in lead I, rS wave in precordial lead V1 and a precordial transition from a negative to a positive QRS complex after lead V4. All six criteria were present in 16 of the 87 patients. No patient with ventricular tachycardia satisfied these criteria, whereas 3 of 34 with supraventricular tachycardia, 1 of 18 with antidromic tachycardia and 12 of 13 with tachycardia using a nodofascicular fiber did. It is concluded that analysis of the surface electrocardiogram during tachycardia may suggest the presence of a nodofascicular fiber.

UR - http://www.scopus.com/inward/record.url?scp=0021327054&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021327054&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(84)80173-4

DO - 10.1016/S0735-1097(84)80173-4

M3 - Article

C2 - 6707368

AN - SCOPUS:0021327054

VL - 3

SP - 1161

EP - 1168

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 5

ER -