Transesophageal Atrial Pacing for the Evaluation of Accessory Atrioventricular Pathways in Wolff-Parkinson-White Syndrome: A Pediatric Case Report and Literature Review.

Arrhythmia induction and identifying the functional characteristics of accessory pathways in Wolff-Parkinson-White (WPW) syndrome typically requires an invasive electrophysiological study. This case reports a 13-year-old boy with a five-year history of paroxysmal palpitations, where transesophageal atrial pacing (TEAP) was used to identify accessory pathways. TEAP revealed multiple tachycardia forms, differentiating orthodromic atrioventricular reentrant tachycardia with narrow and wide QRS complexes. EPS confirmed two pathways, diagnosing WPW syndrome. TEAP effectively assessed accessory pathways' functional characteristics and their roles in tachycardia, showcasing its potential as a minimally invasive diagnostic tool for this condition.