Identical anatomical location of accessory pathway in a family with Wolff-Parkinson-White syndrome

Abstract

Identical location of accessory pathways in family members with Wolff-Parkinson-White syndrome, although theoretically possible, has never been described. A 37-year-old woman and her 18-year-old son were referred for electrophysiological study due to fast rate palpitations and pre-excitation on baseline electrocardiogram. After mapping during pre-excitation, successful radiofrequency application was located at the right free wall in both patients, in an identical anatomical position, on the infero-lateral aspect of the tricuspid ring.

Isolated Wolff-Parkinson-White syndrome in identical twins

“…Relevant to the current case, a separate report identified a mother and her son both with manifest right free wall accessory pathways in identical anatomic locations. 10 In terms of previously published case reports in twins, Lu and colleagues 11 described identical twins who both had left lateral accessory pathways in the same location of the mitral valve annulus, but 1 of the twins did not have pre-excitation on 12-lead ECG and the concealed accessory pathway was discovered at EP study. In older reports, 1 from the 1950s and 2 from the 1970s, the location of the accessory pathway has varied between twins, 12 or only 1 of the 2 twins had evidence of atrioventricular pre-excitation while the other was described as having Lown-Ganong-Levine syndrome with a short PR but no evidence of atrioventricular pre-excitation.…”