A Pre-excited Wide QRS Complex: is That all There is?

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Author(s) A.A.M. Wilde, L.R.C. Dekker
NHJ edition: 2006:03,108
These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here under the prevailing creative commons license with permission from the publisher, Bohn Stafleu Van Loghum.
The ECG can be enlarged twice by clicking on the image and it's first enlargement
Figure 1

A 28-year-old male was referred because of an abnormal ECG. He was having occasional palpitations. His family history is unremarkable. Physical examination revealed no abnormalities. His ECG is shown in figure 1 (standard calibration: 25 mm/s and 10 mm/mV).

What is your diagnosis?

Answer