{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T16:25:49Z","timestamp":1771691149919,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,4,20]],"date-time":"2007-04-20T00:00:00Z","timestamp":1177027200000},"content-version":"vor","delay-in-days":2941,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[1999,4]]},"abstract":"<jats:p>Concealed Nodoventricular Mahaim Fiber. <jats:italic>Introduction<\/jats:italic>: We present the case of a 17\u2010year\u2010old woman who underwent an electrophysiological study and radiofrequency (RF) ablation of supraventricular tachycardia refractory to medical treatment. Two right\u2010sided, concealed, nondecremental atrioventricular accessory pathways (AV\u2010APs) involved in ortho\u2010dromic circus movement tachycardias were identified. After RF ablation of both AV\u2010APs, evidence of bidirectional dual AV nodal conduction was demonstrated and regular narrow complex tachycardia was induced.<\/jats:p><jats:p> <jats:italic>Methods and Results<\/jats:italic>: During the tachycardia, retrograde slow and fast AV nodal pathway conduction with second\u2010degree ventriculoatrial (VA) block and VA dissociation were observed. During the tachycardia with second\u2010degree VA block, ventricular extrastimuli elicited during His\u2010bundle refractoriness advanced the next His potential or terminated the tachycardia. Mapping the right atrial mid\u2010septal region, a distinct high\u2010frequency activation P potential was recorded in a discrete area, two thirds of the way from the His bundle toward the os of the coronary sinus. Detailed electrophysiologic testing with the recordahle P potential demonstrated that the tachycardia utilized a concealed nodoventricular AP arising from the proximal slow AV nodal pathway.<\/jats:p><jats:p> <jats:italic>Conclusion<\/jats:italic>: The tachycardia with slow 1:1 VA conduction could be reset by ventricular extrastimuli elicited during His\u2010bundle refractoriness advancing the subsequent activation P potential and atrial activation. RF ablation guided by recording of the activation P potential resulted in elimination of both the slow AV nodal pathway and the nodoventricular connection with preservation of the normal AV conduction system.<\/jats:p>","DOI":"10.1111\/j.1540-8167.1999.tb00718.x","type":"journal-article","created":{"date-parts":[[2007,4,20]],"date-time":"2007-04-20T14:11:03Z","timestamp":1177078263000},"page":"603-610","source":"Crossref","is-referenced-by-count":25,"title":["Radiofrequency Ablation of a Concealed Nodoventricular Mahaim Fiber Guided by a Discrete 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