Closed-chest electrical ablation (fulguration) of atrioventricular accessory pathway in the Wolff-Parkinson-White syndrome: report of the first case in Hawaii.

Wolff-Parkinson-White (WPW) syndrome is a condition characterized by the presence of an atrioventricular (AV) accessory pathway or bypass tract, which is an extraneous piece of muscular tissue connecting atrium to ventricle. This pathway leads to characteristic findings on the electrocardiogram (EKG). Patients with this syndrome are often asymptomatic, but many frequently have various forms of tachyarrhythmias, some of which may be life-threatening. The conventional therapy is medical, by suppression with antiarrhythmic agents. The established alternative to medical therapy has been surgery, with open-chest excisional ablation of the accessory pathway. In experienced centers, this has a high success rate and holds the promise of cure. Unfortunately, it requires thoracotomy, with its not insignificant associated surgical morbidity.