Atrial fibrillation (AF) occurs in 20% of patients with Wolff-Parkinson-White (WPW) pattern, and atrial flutter in 7%; The presence of an accessory pathway (AP) allows for rapid conduction directly to the ventricles, bypassing the AV node

AFib With Pre-Excitation. May 05, 2014 | Saurabh Aggarwal, MD; ; ; Atul Bhatia, MD. Print; Font Size A A A. Figure 1: A 41-year-old male presented to the emergency department with palpitations. The heart rate was 255 beats/min and the blood pressure was 113/69. Synchronized cardioversion (100, 150 and 200 Joules) was attempted but was unsuccessful.

The two main forms of tachyarrhythmias that occur due to accessory pathways are discussed separately — see atrioventricular re-entry tachycardia (AVRT) and atrial fibrillation/flutter in pre-excitation.

12-lead ECG showing atrial fibrillation in a patient with antegrade conduction through both the AV node and an accessory pathway. The occasional narrow QRS complexes reflect conduction through the AV node, while the wide QRS complexes, with instantaneous rates close to 300 beats per minute, are due to antegrade conduction via an accessory ...

Atrial fibrillation becomes a potentially lethal arrhythmia in the presence of preexcitation because the rapid ventricular activation can result in ventricular fibrillation. Fortunately, radiofrequency ablation is an effective treatment for these ...