Pre-excited atrial fibrillation in a woman with minimal pre-excitation: a case report

Authors

• Komsing Methavigul, Department of Cardiology, Central Chest Institute of ThailandFollow

Abstract

Introduction: A 46-year-old Thai woman presented with palpitation. A 12-lead electrocardiogram (ECG) showed rapid rate of preexcited atrial fibrillation (AF). The subsequent ECG after electrical cardioversion demonstrated minimal preexcitation with short PR interval, and apparently small delta waves only in leads II, III, V₄, and V₅. An electrophysiologic study was performed and showed sinus rhythm with short H-V interval compatible with preexcitation. A programmed electrical stimulation showed orthodromic atrioventricular reentrant tachycardia utilizing left lateral accessory pathway. The catheter ablation was successfully performed via retrograde aortic approach to left lateral accessory pathway. There was no recurrence of Wolff-Parkinson-White (WPW) ECG pattern, supraventricular tachycardia, or AF during 3-month follow-up visit.

Conclusion: This is a rare case of minimal preexcitation presenting with preexcited AF as first presentation. This case reflects minimal preexcitation does not indicate low risk of ventricular fibrillation and sudden cardiac arrest.

DOI

10.56808/2673-060X.5756

Recommended Citation

Methavigul, Komsing (2026) "Pre-excited atrial fibrillation in a woman with minimal pre-excitation: a case report," Chulalongkorn Medical Journal: Vol. 70: Iss. 6, Article 6.
DOI: https://doi.org/10.56808/2673-060X.5756
Available at: https://digital.car.chula.ac.th/clmjournal/vol70/iss6/6