This patient s shortest R

This patient\'s shortest R–R interval on ECG was about 200ms (300bpm), which indicated high risk of sudden cardiac death. The patient underwent catheter ablation. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias [1], which include accessory pathway-mediated arrhythmias, recommend catheter ablation for long-term therapy in patients with symptomatic WPW syndrome (Class I). The classic preexcitation syndrome was described by Wolff, Parkinson, and White in 1930 as an ECG demonstrating bundle branch block with short P–R interval. With advances in clinical electrophysiological study, this syndrome is currently proposed to be due to preexcitation of the c-myc inhibitor by an accessory pathway(s). The prevalence of WPW syndrome has been estimated to be 0.1–0.3% in the general population [2]. The most important clinical consequence of WPW syndrome is supraventricular tachycardia consisting of AV reciprocating tachycardia (AVRT). The incidence of AF in patients with WPW syndrome is reported to be 10–30% [3–5]. No relationship between the onset of AF and localization of accessory pathways has been reported [6], and successful ablation of the accessory pathway prevents the recurrence of AF in the majority of patients. It is known that an accessory pathway is associated with AF, but this mechanism has not been clarified. Recently, a potential role of the pulmonary veins in the development of AF in patients with WPW syndrome was reported [7].
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