Evidence for an intramural origin of idiopathic premature ventricular contractions successfully ablated within the great cardiac vein.
A 37-year-old woman with idiopathic premature ventricular contractions (PVCs), exhibiting a right bundle branch block and inferior axis QRS morphology, underwent electrophysiological testing. The earliest ventricular activation with an isolated prepotential was observed within the great cardiac vein during the PVCs. Pacing from this site with an output of 10 mA produced an excellent pace map, whereas that with an output of 2 mA produced a wider QRS with notches in the early phase. A radiofrequency application delivered at this site eliminated the PVCs. These findings suggested that the PVC origin might have been intramural rather than epicardial.
Yamada
Takumi
T
Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35294-0019, USA. takumi-y@fb4.so-net.ne.jp
McElderry
H Thomas
HT
Doppalapudi
Harish
H
Kay
G Neal
GN
D000328:Adult; D002037:Bundle-Branch Block / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D003331:Coronary Vessels / Q000503:physiopathology / Q000601:surgery; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D014680:Veins / Q000503:physiopathology / Q000601:surgery; D018879:Ventricular Premature Complexes / Q000503:physiopathology / Q000601:surgery*