Catheter-induced mechanical trauma to accesory pathways is an infrequent, u
sually transitory phenomenon related to manipulation of the ablation cathet
er.
We describe a patient with Wolff-Parkinson-White syndrome due to a midsepta
l accessory pathway with recurrent episodes of paroxysmal tachycardias unde
r antiarrhytmic treatment. During the diagnostic electrophysiological study
coinciding with manipulation of the His catheter (5 French), mechanical tr
auma to the accessory pathways occurred, with preexcitation not being recov
ered in the midterm follow up (28 months). This is a exceptional case demon
strating the complexity of the decision making (expectant or rescue ablatio
n) following accidental catheter-induced mechanical trauma.