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What is the underlying cause of this arrhythmia?

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A young athletic female presents with recurrent palpitations which have been as fast as 250 beats per minute.

What is the underlying condition causing her arrhythmia?

Answer: This patient has Wolff-Parkinson-White syndrome (WPW), a condition in which the presence of an accessory pathway leads to preexcitation and symptomatic arrhythmias. Following treatment of the acute arrhythmia, long-term management can be accomplished by ablation of the accessory pathway or antiarrhythmics.

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