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Accessory pathways are rarely seen at the aortic-mitral continuity. A 27-year-old male presented with wide-complex tachycardia. Sinus rhythm electrocardiogram demonstrated pre-excitation, positive in V1-6, I-III, aVF, negative in aVL and aVR. Programmed stimulation showed non-decremental conduction. Morphology of pre-excited beats was similar to ventricular arrhythmias from the left coronary cusp (LCC). Earliest ventricular activation was …

Successful ablation at the left coronary sinus cusp of an accessory pathway at the aortic-mitral continuity