Palpitation case study one

Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S[1]

A young man presented with isolated palpitations. An ECG showed sinus rhythm with preventricular excitation. Physical examination and echocardiography revealed no positive findings. An electrophysiology study eventually revealed the presence of a fasiculoventricular pathway.

• A young man presented with isolated palpitations. *An ECG showed sinus rhythm with ventricular pre-excitation. “Isolated palpitations and ventricular pre‐excitation – Arias – 2020 – Journal of Arrhythmia – Wiley Online Library”.
• Physical examination and echocardiography revealed no positive findings.
• The presence of a positive delta wave in V5 and V6 and a negative wave in V1, raised suspicion for the presence of an accessory pathway.
• A fasiculoventricular accessory pathway is an atypical pathway that connects either the Bundle of His or the fascicles with the ventricular myocardium and the anteroseptal region.
• In the absence of structural heart disease, fasiculoventricular accessory pathways usually present in normal sinus rhythm and the pre-excitation would be minimal.
• An electrophysiology study eventually confirmed the diagnosis.

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