Case 12: Asymptomatic WPW Syndrome in a 16-Year-Old Competitive Football Player

A 16-year-old male football player, who undertakes 4 × 1.5-h training sessions per week and plays a 90-min match on weekends, is being referred for a rhythmological examination because of a ventricular preexcitation syndrome identified on a 12-lead ECG. He has never experienced palpitations and is otherwise asymptomatic. An ECG was conducted as part of a sports medicine consultation and detected preexcitation syndrome. Initially, he was evaluated using an exercise test, but due to the presence of delta wave till maximum heart rate, a Holter ECG was ordered. Upon admission, the patient was hemodynamically and respiratory stable, of normal weight, with regular heart sounds, rate of 102/min, blood pressure of 120/70 mmHg, normal lung sounds, and oxygen saturation of 97%. The ECG showed a short PR interval and a delta wave with a morphology indicating a right postero-septal location of the accessory pathway. No significant biological changes were observed, and echocardiography revealed no structural heart abnormalities (Figs. 18.1, 18.2, 18.3, 18.4, 18.5, 18.6, 18.7, 18.8, 18.9, and 18.10).