Fasciculoventricular Pathway in a Young Athlete—A Case Report

BACKGROUND: Fasciculoventricular pathways (FVPs) are an uncommon cause of pre-excitation that can be mistaken for other more common accessory pathways in clinical practice. This case report highlights the key features of FVPs and their management. CASE SUMMARY: A 12-year-old male athlete was referred to the pediatric arrhythmia outpatient clinic with an asymptomatic pre-excitation on baseline routine electrocardiogram. Exercise stress test showed sustained pre-excitation throughout maximum heart rate. An electrophysiologic study documented an FVP and no inducible arrhythmia. No ablation was attempted, and the patient was discharged with return to play authorization without restrictions. DISCUSSION: Although they are not substrates for re-entrant tachycardia and are not associated with sudden death, diagnosis of FVPs is important to prevent unnecessary ablation and undue exercise restriction.