The accessory pathway in Wolff-Parkinson-White syndrome is a structural defect of the heart that occurs as the organ forms in utero. What causes this additional pathway to form is unknown, though family history appears to play a role in some cases. Research shows the presence of a mutated gene in a rare, inherited form of the syndrome called familial Wolff-Parkinson-White syndrome. The majority of cases occur randomly, with no known cause.

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