Coexistence of atrioventricular block and ventricular pre-excitation is rare. Most reported cases have been associated with structural heart disease and in many patients the atrioventricular (AV) block was incomplete.1-4

A 2 year old boy was referred for evaluation after a routine examination by his general practitioner had detected a slow pulse and a murmur. He was asymptomatic with normal growth and development. On examination he had a regular bradycardia of 65 beats/min and …