A deadly mix - rheumatic mitral stenosis, preexcited atrial fibrillation, left atrial appendage thrombus and left atrial appendage accessory pathway

Rare accessory pathway between a giant left atrial appendage and the left ventricle

“…Its features include the potential of causing ventricular fibrillation (VF) owing to a short effective refractory period (ERP) of the AP and the coexistence of multiple APs or an AP between the right atrial appendage and right ventricle, and it can cause difficulty in performing endocardial ablation. [1][2][3][4][5][6][7] We report a case of a 6-year-old boy with multiple APs including an LAA-LV AP, giant LAA, and LV noncompaction (LVNC). Little has been reported on LAA-LV APs associated with a giant LAA.…”