Anterior ST Elevation Post-WPW Ablation: A Case of Long-Term Electrotonic Modulation.

A 47-year-old male with Wolff-Parkinson-White syndrome (WPW) and left ventricular hypertrophy (LVH) was admitted for transient loss of consciousness. Intracardiac electrophysiological examination identified a left posterior septal accessory pathway, which was successfully ablated via radiofrequency catheter ablation. Postoperative electrocardiogram (ECG) showed J-ST segment elevation in anterior leads V2-V4. At 2-week follow-up, the J point and ST segment elevation in leads V2-V4 had diminished but not fully resolved. Due to the electrotonic modulation mechanism, WPW patients may develop anterior ST-segment elevation post-ablation, and LVH may prolong the time for the ST segments to normalize.