A 22-year-old woman in the 21st week of her first pregnancy without the history of heart disease was admitted to our department for electrophysiology study because of the documented symptomatic narrow QRS tachycardia. To prevent foetal X-ray exposure, three-dimensional (3D) electroanatomic mapping (EAM) system EnSite/NavX (St. Jude Medical) was used (Figure 1A). During the placement of catheters, we recorded a spontaneous induction of the orthodromic atrioventricular re-entrant tachycardia (AVRT) with the first atrial activation in the distal coronary sinus (Figure 1B), indicating the presence of a left accessory pathway. Transseptal puncture was performed with the aid of intracardiac echocardiography and without fluoroscopy. Radiofrequency ablation in the area of the earliest left atrial activation terminated the AVRT. Figure 1A shows a partial 3D EAM of the...

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