Discordant junctional beats and preexcitation: what is the mechanism?

@article{Ali2015DiscordantJB,
  title={Discordant junctional beats and preexcitation: what is the mechanism?},
  author={Hussam Ali and Antonio Sorgente and Pierpaolo Lupo and Riccardo Cappato},
  journal={Circulation. Arrhythmia and electrophysiology},
  year={2015},
  volume={8 4},
  pages={
          991-2
        }
}
An 18-year-old woman with Down syndrome and ventricular preexcitation was referred to our center for electrophysiological evaluation. She had no structural heart disease, and her 12-lead ECG showed minimal preexcitation. After obtaining an informed consent, an electrophysiology study was performed under conscious sedation. Via bilateral femoral veins, multipolar diagnostic catheters were introduced and positioned at the His bundle region and coronary sinus. A roving quadripolar catheter was… Expand

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TLDR
The NFV pathway was a critical part of the tachycardia circuit in 1 and proved to be a bystander in the other 3 cases, and programmed extrastimuli showed evidence of a decremental accessory pathway in 3 of the 4 cases. Expand
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