Bundle of Kent
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Synonyms and keywords: Accessory atrioventricular muscle bundle, Kent Bundle, Kent pathway
Overview
Bundle of Kent is an accessory conducting pathway between the atria and the ventricle of the heart.
Historical Perspective
Paladina and Kent were the first to describe the myocardial fibers connecting the atrial and ventricular myocardium in normal hearts. In 1932, Holzmann and Scherf suggested that ventricular pre-excitation was possible through these muscular connections. Later, Wood and his colleagues and subsequently Ohnell described the first anatomical pathways for these accessory atrioventricular connections.
Pathophysiology
Bundle of Kent is an abnormal pathway present in a small percentage of the general population that results in a condition known as Wolff-Parkinson-White syndrome (WPW). The anatomic substrate is a band of myocytes that bridges the fibrous junction between the atrium and the ventricle.
Conditions Involving Bundle of Kent
Problems arise when this pathway creates an electrical circuit that bypasses the AV node. The AV node has rate-slowing electrical regulatory properties, whereas the pathway via the bundle of Kent does not. When an aberrant electrical impulse travels through the Kent bundle, tachyarrhythmia ensues.
Treatment
In order to treat persons with Wolff-Parkinson-White syndrome, destruction of the bundle of Kent is accomplished by radiofrequency catheter ablation. This procedure is performed almost exclusively by cardiac electrophysiologists.