Patient: Shortness of breath, chest tightness Untreated Whether surgery is needed, and if so, when is the best time Laboratory and test results: Sinus arrhythmia, mean heart rate 92 bpm, minimum heart rate 54, maximum heart rate 157, intermittent pre-excitation syndrome, secondary st-t changes. Last seen at: Hospital Pediatric Cardiology: The age of surgery is no longer an issue, the need for surgery depends on: 1. whether there is a history of tachycardia episodes; 2. whether the location of the additional bypass is safe for surgery (need to see the ECG with preexcitation). Patient: Hi Dr. Li, thank you very much for your reply in your busy schedule and I admire your high medical ethics. I have uploaded 4 ECG reports with photos, I wonder if you can see them. Hospital Pediatric Cardiology: According to the ECG localization, the bypass is located near the right wall and surgery can be considered.