Abstract
A 31-year-old man was referred with a history of syncope and recurrent palpitations for 16 years. During an episode of palpitation, regular tachycardia with right bundle branch block and 1:1 ventriculoatrial conduction was documented on the 12-lead electrocardiogram (ECG). In sinus rhythm, the ECG revealed preexcitation with a usual small R wave in lead V1 and a positive delta wave in lead I, lead aVL, and the inferior leads (δ in lead III<lead II) (Figure 1). The ECG findings were consistent with a right anteroseptal pathway.
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