Recovery from sudden death in a young patient with intermittent and asymptomatic ventricular preexcitation

Should we be more invasive in the diagnosis and treatment?

Abstract

Intermittent ventricular pre-excitation, evaluated by complementary non-invasive methods, such as the 24-h electrocardiographic Holter and the graded ergometer test, provide information on the antegrade conduction capacity of the accessory pathway. For years it has been the subject of study, publications and discussions on the management, follow-up and treatment that should be performed on these patients. There are conservative schools that choose not to invade the patient, while others consider that invasive electrophysiology is the only tool capable of inexorably preventing the appearance of arrhythmias in which the path plays a leading role. The aim to report this infrequent case of an adolescent with intermittent and asymptomatic pre-excitation, with non-invasive follow-up for 10 years, in another center, who debuted with a syncopal episode and sudden death successfully recovered, then ablated successfully the left lateral accessory pathway without complications is to review te literature about the true "benignity" of the pathways accessory.