Case 18: Low-Risk Accessory Pathway in a 18-Year-Old Male Football Player

An asymptomatic 18-year-old male who participated in recreational football and has been diagnosed with ventricular preexcitation underwent noninvasive assessment by stress test and Holter ECG to determine the arrhythmic risk of the accessory pathway. The 12 lead ECG shows a short PR interval of 110 ms and a delta wave, suggestive of an asymptomatic accessory pathway. Echocardiography revealed a heart of normal size, with no valvulopathies, and an ejection fraction of >50% (Figs. 24.1, 24.2, 24.3, 24.4, 24.5, 24.6, 24.7, 24.8, 24.9, 24.10, 24.11, 24.12, 24.13, 24.14, 24.15, 24.16, 24.17, 24.18, 24.19, 24.20, 24.21, 24.22, 24.23, 24.24, and 24.25).