Radiofrequency ablation of an epicardial accessory pathway in 19-year-old male

Case Report A 19-year-old man with a history of palpitations and syncope was referred for Wolff-Parkinson-White syndrome (WPW) ablation. The patient had undergone a previous unsuccessful procedure. Since then, despite administration of beta-blockers he had experienced a few arrhythmic episodes terminated by Valsalva maneuvers. The surface electrogram (ECG) showed a short PR interval, a positive delta wave in leads II, III, and aVF and a negative one in precordial leads V1 and V2 (Fig. 1A). During the electrophysiological study maximal preexcitation confirmed the preexcitation pattern (Fig. 1B, 3A). An algorithm used to