Accessory atrioventricular pathway in an infant: prediction of location with body surface maps and ablation with cryosurgery.

A 10-month-old infant with multiple muscular ventricular septal defects, congestive heart failure, Wolff-Parkinson-White syndrome, and supraventricular tachycardia is presented. The site of ventricular pre-excitation was predicted by analysis of ST-T wave isopotential body surface maps to be in the posterior free wall of the right ventricle. The site was confirmed by epicardial mapping of the ventricles during surgery. The pathyway was cryoblated and the ventricular defects were closed. The patient has been free of pre-excitation and supraventricular tachycardia for over two years since surgery.