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http://dx.doi.org/10.1016/j.hrthm.2006.03.033DOI Listing

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Article Synopsis
  • Hypertrophic cardiomyopathy (HCM) is a prevalent yet often overlooked heart condition.
  • Fasciculoventricular bypass tract (FVBT) is a rare occurrence, and their simultaneous presence is documented in Danon disease.
  • A case study is presented of a family with HCM and FVBT linked to a specific genetic variant in the MYBPC3 gene.
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Fasciculoventricular accessory pathways are rare variants of preexcitation. The differential diagnosis of fasciculoventricular accessory pathways from other preexcitation variants can be challenging. Based on two cases, we discuss the specific electrocardiographic and electrophysiologic features of fasciculoventricular bypass tracts.

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Fasciculoventricular accessory pathway unmasked by a pseudo gap phenomenon.

J Electrocardiol

June 2021

Department of Cardiology, Huashan Hospital Fudan University, 12 Wulumuqizhong Road, Shanghai 200040, China. Electronic address:

A 28 year old female with manifest preexcitation underwent electrophysiology study for intermittent palpitation. During progressively premature atrial extrastimuli, bypass tract was blocked before relative refractory period of AV node, making it unfeasible to observe the change of H-V interval and QRS morphology during decremental nodal conduction. However, dual AV node physiology, presented as a marked increase of A-H interval, occurred when a short-coupled extrastimulus was delivered, followed by a preexcited QRS with an H-V interval identical to that in sinus rhythm.

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Background: Fasciculoventricular (FV) bypass tracts (BTs) are the rarest form of ventricular preexcitation. Although they are not involved in clinically significant reentrant tachycardia, they may cause diagnostic and therapeutic confusion if not properly understood. This study aimed to assess the impact of FV BTs on the diagnosis and treatment of concomitant arrhythmias and cardiac diseases.

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