A case report of a patient with wide complex tachycardia due to Wolff–Parkinson–White syndrome mimicking ventricular tachycardia

Abstract

Background Wide complex tachycardia (WCT) associated with syncope as manifestation of an underlying, life-threatening arrhythmia might potentially be the harbinger of sudden cardiac death. Identifying the etiology of a WCT is imperative to provide appropriate treatment and prevent recurrence. Case summary We report the case of a 22-year-old male who had been experiencing hemodynamically significant wide complex tachycardia (WCT) leading to syncope at the age of 13 years. As the patient and the family rejected an electrophysiological (EP) study, he had received an implantable cardioverter defibrillator (ICD) for secondary prevention. After seven years experiencing multiple shocks, the patient finally gave consent to an EP study which identified a left-sided accessory atrioventricular pathway that was successfully ablated during the same procedure. Discussion The differential diagnosis of WCT might be challenging and includes both ventricular and supraventricular tachycardias. In young patients without structural heart disease experiencing WCT, an EP study should be offered before ICD implantation to make a final diagnosis with the potential to provide definitive treatment.