Successful transseptal catheter ablation of premature ventricular contractions arising from the mitral annulus: a case with a pure annular origin.
A 74-year-old man with symptomatic premature ventricular contractions (PVCs) with a right bundle branch block and right inferior axis QRS morphology underwent electrophysiologic testing. During the PVCs, coronary sinus mapping revealed ventricular prepotentials with the earliest activation in the distal great cardiac vein (GCV) where the local ventricular electrograms were smaller in amplitude than the atrial electrograms. The transaortic approach could not reach the earliest activation site within the GCV, but the transseptal catheter ablation successfully eliminated the PVCs on the mitral valve. With catheter ablation of ventricular arrhythmias with pure mitral annular origins, a transseptal approach may be necessary.
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. takumi-y@fb4.so-net.ne.jp
Takumi
T
Yamada
H Thomas
HT
McElderry
J Scott
JS
Allison
Harish
H
Doppalapudi
Andrew E
AE
Epstein
Vance J
VJ
Plumb
G Neal
GN
Kay
D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000601:surgery*