Ventricular fibrillation in a patient with ventricular preexcitation is usually due to atrial fibrillation with an extremely rapid ventricular rate from which it degenerates. We present a case with Wolff-Parkinson-White syndrome and coexistent idiopathic ventricular fibrillation. The patient, a 23-year-old male, had had a cardiac arrest four years earlier. In electrophysiological study, the accessory pathway was located in the left posteroseptal region and successfully eliminated with

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... ency catheter ablation. After the ablation procedure, ventricular fibrillation was induced with programmed ventricular stimulation. A dual chamber implantable cardioverter defibrillator was implanted in the patient. (Jpn Heart J 2002; 43: 283-287) PATIENTS with Wolff-Parkinson-White (WPW) syndrome usually complain of palpitations, sometimes associated with chest discomfort, dyspnea, light-headedness, or syncope. Sudden cardiac death is rare but it may be the first manifestation of this syndrome. The estimated sudden death incidence in ventricular preexcitation is nearly 0.1% a year and it usually occurs as a result of atrial fibrillation with an extremely rapid ventricular rate due to conduction over the accessory pathway that degenerates into ventricular fibrillation (VF). 1, 2) In this report, we present a case with WPW syndrome and coexistent idiopathic VF whose mechanism is not related to preexcitation. CASE REPORT A 23-year-old Turkish man presented with palpitation episodes that had continued over the last 5 years. He had a history of cardiac arrest and cardiopulmonary resuscitation that occurred 4 years earlier, but no detailed information or