This is the case of a 35-year old male physician presenting with a 12-year history of palpitations despite oral metoprolol. He had reversible left hemiparesis with right hemispheric lacunar infarctions on computerized tomography scan.

Brugada syndrome is an inherited form of arrythmogenic disease associated with a coved-type ST segment elevation in right precordial leads and an increased risk of sudden cardiac death due to ventricular fibrillation (VF) in young, otherwise healthy adults.

Fetal tachycardia can occur in approximately 0.4% to 0.6% of all pregnancies. The most common forms of fetal tachycardias are SVT and atrial flutter. Sustained tachyarrhythmia can lead to congestive heart failure, hydrops, severe neurologic morbidity, or fetal or neonatal demise. 

Arrhythmias in children may be benign or life threatening. Some may produce only mild, non-specific symptoms. Thus, specific documentations of arrhythmia, such as electrocardiogram and Holter monitoring, correlated with reported symptoms, are critical in establishing the diagnosis. Long QT syndrome (LQTS) is rare in pediatric patients compared with adults. It may either be inherited or acquired, and results in abnormalities in the ventricular repolarization leading to ventricular arrhythmia, which can be fatal. 

The objective is to report a case of a successful anteroseptal accessory pathway ablation in a 32-year old male with  symptomatic Wolf-Parkinson-White (WPW) syndrome with the guidance of three-dimensional (3D) electroanatomical mapping.