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Electrocardiographic and epicardial mapping studies are reported in a child with an atrial septal defect and a variant of type A Wolff-Parkinson-White (WPW) syndrome. The vectorcardiogram suggested a posterior area of early activation and this was confirmed by epicardial mapping studies. Premature activation apparently occurred from a site near the endocardium of the basal region of the left ventricle and surgical interruption could not be planned on the basis of data provided by epicardial mapping.The role of vectorcardiography in assessing patients with the WPW syndrome is discussed.

Epicardial Mapping in a Variant of Type A Wolff-Parkinson-White Syndrome