Atrial fibrillation and Wolf-Parkinson-White syndrome in a 68 year old patient with tuberous sclerosis

Tuberous sclerosis is an autosomal-dominant disease with involvement of several organs, the heart included. The cardiac anomaly most frequently found is the rhabdomyoma association. However, WPW association has also been encountered more common than usual. In the majority of the published related-series, infant or adolescent patients are described. We report the case of a 68 year old patient with tuberous sclerosis whose first cardiac manifestation was a pre-excited atrial fibrillation. This association is reviewed and the consideration of accesory pathways is highlighted as the first mechanism to take into account when arrhythmias are present in these patients even in adult age.