Successful Catheter Ablation in an Infant With Multiple Accessory Pathways and Incessant Arrhythmia

Wolff–Parkinson–White (WPW) syndrome is a common cause of supraventricular tachycardia encountered in childhood. We herein describe a 2-month-old male infant with paroxysmal supraventricular tachycardia that was refractory to multiple antiarrhythmic medications. The diagnosis of orthodromic reciprocating tachycardia over multiple accessory pathways was confirmed by meticulous mapping. One of the accessory pathways was located in the mid-septal region, and it acted as the retrograde limb in the arrhythmia circuit. The other accessory pathway was located in the right free-wall region, and it intermittently acted as the antegrade limb of the arrhythmia. Ablating the mid-septal accessory pathway eliminated the arrhythmia. (Iranian Heart Journal 2021; 22(2): 119-123)