title: Successful ablation of Hisian ectopy identified by a reversed His bundle activation sequence.
abstract: Junctional ectopy or tachycardia have been mapped and ablated in the atrioventricular node or its posterior extensions. There is no report of Hisian ectopy convincingly demonstrated and then successfully treated by ablation. A 39-year-old man presented with a 9-year history of recurrent supraventricular ectopy refractory to medical treatment. Intracardiac mapping revealed that the ectopy originated from the His bundle, which was indicated by a reversed His bundle activation sequence during ectopy compared to that during sinus rhythm, while the right bundle branch potential was anterogradely activated. Low power RF energy delivered to the site of earliest activation completely abolished the ectopic activity without modification of Hisian or atrioventricular conduction. After a 12-month followup, the patient remains free of recurrence.
authors: Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. jacques.clementy@pu.u-bordeaux2.fr
authors: Kee-Joon
authors: KJ
authors: Choi
authors: Dipen C
authors: DC
authors: Shah
authors: Pierre
authors: P
authors: Jais
authors: Meleze
authors: M
authors: Hocini
authors: Teiichi
authors: T
authors: Yamane
authors: Laurent
authors: L
authors: Macle
authors: Michel
authors: M
authors: Haissaguerre
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy*; D002036:Bundle of His / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D012008:Recurrence