A 22 year old man with WPW syndrome and a structurally normal
heart was admitted for the treatment of recurrent paroxysmal tachycardia.
Induction protocols gave interesting clues for existence of
more than one tachycardia mechanism. Five different tachycardia
were demonstrated, the substrates being a right free wall accessory
pathway (AP), a left lateral AP and dual AV nodal physiology.
Successful ablation at 3 sites (lateral tricuspid annulus, lateral mitral annulus
and slow pathway) in the same session led to complete elimination of
these tachycardia mechanisms.
Key words: AVRT, His refractory, Outflow VT, Fascicular VT, Slow pathway
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