Abstract
Wolff-Parkinson-White (WPW) syndrome is a potentially life-threatening condition for which catheter ablation is considered first-line therapy, yet electrophysiology (EP) services remain unavailable in many low-and middle-income countries. We describe the innovative use of a pacemaker programmer as an EP recording system for the first catheter ablation procedures performed in Fiji. Two patients with symptomatic WPW underwent ablation using a repurposed pacemaker programmer for intracardiac signal recording in combination with an IBI-1500T9 radiofrequency generator for energy delivery. Both procedures were successful, achieving elimination of accessory pathway conduction and complete resolution of symptoms without complications. These cases demonstrate that repurposing readily available cardiac device equipment can enable life-saving EP procedures in resource limited settings and establish a foundation for future service development.