Case report: : In our case the presence of accessory pathway in the Wolff-Parkinson-White (WPW) syndrome confers an increased risk of developing lethal arrhythmias and sudden cardiac death (SCD). The underlying arrhythmia causing SCD is VF triggered by pre-excited AF. In certain subset of patients, pre-excitation can be latent or intermittent, because of preferential conduction through AV node. In this case pre-excitation became manifest because of the damage and erosion of the AV node caused by aortic valve endocarditis and septal abscess. LV dysfunction may occur secondary to tachy-arrhythmias, either symptomatic or asymptomatic, that trigger achycardia induced cardiomyopathy (TIC). The rate and duration of tachy-arrhythmias influence the speed at which TIC develops and LV dysfunction may occur as early as 24 hours after the onset of tachy-arrhythmia. Nonetheless, resolution of LV systolic function occurs with adequate rate control or ablation. In this case; eccentric ventricular activation secondary to pre-excitation, in a vulnerable myocardium (post operative phase and pre-existing LV dilatation) contributed to the development of cardiomyopathy. This process was reversed by ablation of the accessory pathway and implantation of CRT, which resulted in normalization of LV function and reversal of dilated cardiomyopathy.