Wolff-Parkinson-White syndrome is rarely associated with a right atrial aneurysm. However, when such a condition occurs, it is hard to manage since pre-excitation is induced as long as the aneurysm persists. In this case is 14-year-old female patient who receivs emergency treatment for irregular wide QRS complex tachycardia, and a pre-excitation pattern was then observed on the surface electrocardiogram reported. An initial electrophysiological study reveals a high-risk right posterior accessory pathway that is resistant to both radiofrequency and irrigated radiofrequency ablations. Subsequently, fluoroscopy shows that this is due to a right atrial aneurysm. Although successful ablation with irrigated radiofrequency is performed in the second procedure, the procedure is considered suboptimal due to the association of aneurysm. Accordingly, anti-thrombotic and anti-arrhythmic drug therapy is initiated. It is decided to omit surgery. The patient is followed under medical treatment for 2 years without complications. Read the full article here.
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