{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:55:52Z","timestamp":1776142552872,"version":"3.50.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radiofrequency ablation (RFA) remains the gold standard for Wolff-Parkinson-White (WPW) syndrome with \u223c94% acute success, \u223c6% recurrence. Pulsed field ablation (PFA) shows promise for complex accessory pathways (APs) but lacks data on oblique courses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 36-year-old endurance athlete presented with incidental right paraseptal pre-excitation before methylphenidate initiation. He reported self-terminating palpitations (\u223c200 bpm) during moderate cycling. Electrophysiological study revealed an oblique inferoparaseptal AP with right atrial insertion (inferior interatrial septum\/CS roof, Kent potential) and left inferoparaseptal ventricular exit (earliest retrograde activation mid-CS 5\/6). Due to right coronary artery proximity, focal PFA via Centauri\u2122 system (Galvanize) achieved complete CS ostium\/roof block. Post-procedure ventricular pacing showed retrograde decremental conduction. At 3 months, he reported no tachycardias\/palpitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/conclusion<\/jats:title>\n                    <jats:p>This case demonstrates focal PFA's feasibility for an underrepresented oblique inferoparaseptal AP amid complex CS\/CSMC anatomy, avoiding RFA's coronary injury risk. While early PFA series report &amp;gt;99% acute success, randomized long-term data vs. RFA are needed. PFA represents a promising investigational approach for anatomically challenging APs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1801903","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:21:46Z","timestamp":1776140506000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Pulsed field ablation of an oblique inferoparaseptal accessory pathway"],"prefix":"10.3389","volume":"13","author":[{"given":"Hans","family":"Ebbinghaus","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Sankt Georg","place":["Leipzig, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Sankt Georg","place":["Leipzig, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.ihj.2023.02.001","article-title":"The success rate of radiofrequency catheter ablation in wolff-Parkinson-white-syndrome patients: a systematic review and meta-analysis","volume":"75","author":"Ibrahim Ali Sherdia","year":"2023","journal-title":"Indian Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1161\/CIRCULATIONAHA.114.011154","article-title":"Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients","volume":"130","author":"Pappone","year":"2014","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1093\/europace\/euu176","article-title":"Radiofrequency ablation of accessory pathways in patients with the wolff-Parkinson-white syndrome: the long-term mortality and risk of atrial fibrillation","volume":"17","author":"Borregaard","year":"2015","journal-title":"Europace"},{"key":"B4","doi-asserted-by":"publisher","first-page":"euaf085.084","DOI":"10.1093\/europace\/euaf085.084","article-title":"Radiofrequency ablation for the treatment of wolff-Parkinson-white syndrome: experience in 1,239 cases","volume":"27","author":"Xavier","year":"2025","journal-title":"Europace"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1093\/europace\/eux115","article-title":"Radiofrequency ablation of accessory pathways in patients with the wolff\u2013Parkinson\u2013white syndrome: long-term risk of mortality and coronary events","volume":"20","author":"Wongcharoen","year":"2018","journal-title":"EP Eur"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e013206","DOI":"10.1161\/CIRCEP.124.013206","article-title":"Pulsed field ablation of paroxysmal supraventricular tachycardia: a prospective multicenter single-arm study in China","volume":"17","author":"Li","year":"2024","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1016\/j.hrthm.2024.03.030","article-title":"Ablation of accessory pathways in different anatomic locations using focal pulsed field ablation","volume":"21","author":"Bre\u0161kovi\u0107","year":"2024","journal-title":"Heart Rhythm"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1016\/j.jacep.2018.03.018","article-title":"Maximal Pre-excitation based algorithm for localization of manifest accessory pathways in adults","volume":"4","author":"Pambrun","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.52083\/BNUM8219","article-title":"The coronary sinus and adjacent structures in human adult hearts: morphometrical cadaveric anatomy","volume":"26","author":"Dmitrieva","year":"2022","journal-title":"Eur J Anat"},{"key":"B10","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s43044-023-00362-5","article-title":"Would a complete electrophysiological study allow US to make a correct diagnosis?","volume":"75","author":"Ch\u00e1vez-Gonz\u00e1lez","year":"2023","journal-title":"Case Report. 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