[Not Available].

A 63-year-old mand with permanent atrial fibrillation through five years presents to the emergency room with dyspnea and an ECG showing pre-excited afib. The ECG was initially perceived as afib with bundle branch block and treated with digoxin. After that, treatment with amiodaron was given; also without success. After DC-conversion, multiple times and relapse, the patient was transferred to a highly specialised hospital, and an accessory pathway was performed ablated. This is a case report of a patient who had permanent atrial fibrillation and whose initial presentation of Wolff-Parkinson White syndrome was pre-excited atrial fibrillation.