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March 23, 2025Journal of Cardiovascular Electrophysiology

An Unpredictable Atrioventricular Accessory Pathway: Low‐Risk or High‐Risk?

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Key result

Intermittent ventricular preexcitation documented at low heart rates does not exclude the presence of an accessory pathway with high-risk conduction properties during follow-up.

Population

A 66-year-old man with known asymptomatic preexcitation and symptomatic complete infranodal atrioventricular…

Design

Case_report

Follow-up

4 months

Authors

TSTommaso SciarrettaUniversity of PaduaDGDavide GenoveseCardiac ImagingGPGiacomo PreteCa' Foncello Hospital

Discussion

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Overview

Pacemaker implantation without pathway ablation risks rapid preexcited arrhythmias in intermittent preexcitation; leaves open optimal pre-implant risk stratification.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 66-year-old man with known asymptomatic preexcitation and complete infranodal atrioventricular block who developed preexcited atrial fibrillation 4 months after pacemaker implantation.
I
Intervention
Bicameral pacemaker implantation followed by accessory pathway catheter ablation
O
Outcome
Development of preexcited rapidly conducted atrial fibrillation and successful ablation

Intermittent ventricular preexcitation documented at low heart rates does not reliably exclude the presence of an accessory pathway with high-risk conduction properties.

Cite This Study

Sciarretta et al. (2025) conducted a case report in Asymptomatic preexcitation and complete infranodal atrioventricular block (n=1). Bicameral pacemaker implantation and accessory pathway catheter ablation was evaluated on Development of preexcited, rapidly conducted atrial fibrillation. Intermittent ventricular preexcitation documented at low heart rates does not exclude the presence of an accessory pathway with high-risk conduction properties during follow-up.

synapsesocial.com/papers/6ab9f80fe77490bc77b1a99bhttps://doi.org/10.1111/jce.16640
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Electrophysiologic Demonstration of an Atriofascicular Accessory Pathway1988 · 4 citations
  2. 2Multiple Concealed Accessory Pathways Associate with Antegrade Triple AV Nodal Pathways and Catheter Ablation1985
  3. 3Development of Rapid Preexcited Ventricular Response to Atrial Fibrillation in a Patient with Intermittent Preexcitation2012 · 36 citations
  4. 4Multiple accessory pathways in patients with the pre-excitation syndrome.1976 · 175 citations
  5. 5Latent Atriofascicular Pathway Participating in a Wide Complex Tachycardia: Differentiation from Ventricular Tachycardia2006 · 3 citations