title: Idiopathic mitral annular PVCs with multiple breakouts and preferential conduction unmasked by radiofrequency catheter ablation.
abstract: A 39-year-old man with idiopathic monomorphic premature ventricular contractions (PVCs), exhibiting a right bundle branch block and inferior axis QRS morphology, underwent electrophysiological testing. After a radiofrequency (RF) application to the anterior mitral annulus (MA) eliminated the spontaneous PVC morphology, a second PVC morphology occurred. Pacing from the first ablation site exhibited an excellent match to the second PVCs with a long stimulus to QRS interval. An RF application delivered near the first lesion eliminated all PVCs. The MA PVCs in this case exhibited a single origin with multiple breakouts and preferential conduction that were unmasked by RF ablation.
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 35294–0019, USA.
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamada
authors.forename: Harish
authors.initials: H
authors.lastname: Doppalapudi
authors.forename: H Thomas
authors.initials: HT
authors.lastname: McElderry
authors.forename: G Neal
authors.initials: GN
authors.lastname: Kay
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000379:methods; D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*