Real-time integration of intracardiac echocardiography and electroanatomic mapping in PVCs arising from the LV anterior papillary muscle.
A 54-year-old woman with idiopathic premature ventricular contractions (PVCs) underwent electrophysiological testing. Three-dimensional (3D) geometries of the papillary muscles and chamber of the left ventricle (LV) were reconstructed using a CARTO-based 3D ultrasound imaging system (Biosense Webster Inc., Diamond Bar, CA, USA) during the PVCs. Activation mapping in the LV was then performed during the PVCs and the activation map revealed the earliest ventricular activation on the anterior papillary muscle. An irrigated radiofrequency current delivered at that site with guidance from that system eliminated the PVCs. This case may suggest that the guidance system may be feasible and useful for catheter ablation of PVCs arising from uncommon sites.
Yamada
Takumi
T
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA. takumi-y@fb4.so-net.ne.jp
McElderry
H Thomas
HT
Doppalapudi
Harish
H
Kay
G Neal
GN
D018780:Body Surface Potential Mapping / Q000379:methods*; D003199:Computer Systems; D005260:Female; D006329:Heart Conduction System; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D010210:Papillary Muscles; D013382:Subtraction Technique; D018511:Systems Integration; D018084:Ultrasonography, Interventional / Q000379:methods*; D018879:Ventricular Premature Complexes / Q000175:diagnosis*