First presentation of atrial fibrillation with pre-excitation syndrome in octogenarian

Abstract

Palpitation is a symptom of cardiac arrhythmia commonly presented at hospital admission. It has a wide range of clinical importance, from subtle insignificant cardiac ectopic beats to life-threatening cardiac arrhythmias with a risk of sudden cardiac death. Approach to palpitation emphasizes on the identification of its primary cause which relies strongly on the underlying risk factors and age groups. Cardiac arrhythmias due to innate cardiac conductive disorders such as accessory pathway in Wolff-Parkinson-White syndrome tend to present at a younger age while arrhythmias related to ischemic heart disease occur mostly in the elderly population. We report a case of first diagnosed atrial fibrillation in an 81-year-old patient with previously unknown pre-excitation syndrome.