Summary: This week we review a recent work from the team at Children's LA about an unusual form of pre-excitation and use this as a place to launch a discussion about pre-excitation. What sorts of pathways cause pre-excitation? Should all pre-excited patients undergo formal testing? Should all pathways be ablated? How can we invasively or non-invasively assess these patients and are these approaches reliable? We have 2 noted experts on this topic - Professor Michael Silka of USC and Professor Steven Fishberger of Spokane, Washington and U. Miami. This is a rare opportunity to hear 2 'gurus' on pediatric electrophysiology 'riff' on a topic about which they each have encyclopedic knowledge. <a href="https://doi.org/10.1017/s1047951121000056" rel="noopener">https://doi.org/10.1017/s1047951121000056</a>
