Conflicting invasive electrophysiological study results in a suspected fasciculoventricular pathway: a case report

Three potential anatomical locations of the upper FVP take-off side were considered: (i) a single FVP originating from the lower part of the His-bundle or (ii) a single FVP originating close to the upper, junctional part of the His-bundle or even from the distal part of the AV-node and (iii) the presence of an additional second accessory pathway. Based on the above-mentioned evidence, the second anatomical location of the upper FVP-insertion was most likely, differing from previous findings of FVP in the literature. A conservative, observational management strategy was adopted. Current diagnostic criteria for FVP are based on retrospective studies and case reports, lacking prospective validation. This case underscores the need for further research to refine the diagnostic approach to FVP and improve risk stratification in such patients.