Journal of Investigative Medicine High Impact Case Reports (Jan 2022)

Pre-excitation Due to Fascicular-Ventricular Pathway: An Electrocardiographic Diagnosis: A Case Report

  • Richard A. Lange MD, MBA,
  • Victoria Nguyen MS,
  • Zainul Abedin MD

DOI
https://doi.org/10.1177/23247096211073261
Journal volume & issue
Vol. 10

Abstract

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A 79-year-old Caucasian male was referred to cardiology clinic because the electrocardiogram showed premature atrial complexes and pre-excitation (delta waves) thought to be consistent with Wolff-Parkinson-White (WPW) syndrome. He did not report symptoms of palpitations or syncope. Careful analysis of the electrocardiogram revealed a fascicular-ventricular pathway (FVP) responsible for pre-excitation. Differentiating FVP from WPW syndrome is essential as the risk profile is different with each. Electrocardiographic observations that could help identify the presence of an FVP and its diagnostic, prognostic, and therapeutic implications are presented.