A 40-year-old man with a history of obesity and cannabis use consulted for an episode of sudden onset palpitations and chest pain. The electrocardiogram showed a preexcitation pattern compatible with WPW syndrome. Catheter ablation was indicated. The electrophysiological study documented a left posterolateral accessory pathway at the level of the posterolateral mitral annulus, with anterograde and retrograde conduction; however, the catheter could not be positioned at the site, with poor contact, so modulation of the endocardial arrhythmic substrate was considered with ambulatory three-dimensional electroanatomic mapping system.  

A 74-year-old man who for 6 years presented cervical pain radiating to the dorsolumbar area, with physical activity as well as at rest, and progressive functional limitation of the neck for movements until flexion and rotation were compromised. The cervical spine X-ray showed cascade calcification of theanterolateral aspect from C2 to C6, without compromising the height of the vertebral bodies; and, in the dorsolumbar spine showed hyperostosis of the contiguous dorsolumbar vertebral bodies, without affecting the sacroiliac joints. Diffuse idiopathic skeletal hyperostosis (DISH) is a disease characterized by calcification and ossification of different joint structures, affecting the cervical, dorsal or lumbar spine, with a predisposition to ossification of the anterior longitudinal ligament and, to a lesser extent, of the posterior longitudinal ligament.