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Electrophysiology study was diagnostic for antidromic atrioventricular (AV) reentrant tachycardia utilizing a muscular connection from the anterior interventricular vein to the left ventricle with Mahaim\u2010like properties, successfully treated with ablation in the distal coronary sinus (CS) system. This case highlights accessory pathways (a) with unique features (i.e., Mahaim\u2010like characteristics) and (b) involving musculature from the distal CS system, thereby limiting the value of endocardial ablation for durable treatment. Importantly, the coronary venous system is an accessible vascular network for evaluation and catheter ablation of such arrhythmias.<\/jats:p>","DOI":"10.1111\/pace.14024","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T04:35:59Z","timestamp":1597379759000},"page":"185-188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Uncovering a unique path: Antidromic AVRT utilizing a left anteroseptal Mahaim\u2010like accessory pathway"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6435-5746","authenticated-orcid":false,"given":"Amneet","family":"Sandhu","sequence":"first","affiliation":[{"name":"Section of Electrophysiology The University of Colorado  Aurora Colorado"},{"name":"Section of Electrophysiology Rocky Mountain Regional VA Medical Center  Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy 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