title: Extensive preferential pathway ablation for the elimination of premature ventricular contractions arising from the right ventricular outflow tract.
abstract: A 76 y/o women presented with 2 different types of premature ventricular contractions (VPCs 1 and 2) arising from the right ventricular outflow tract (RVOT). Catheter ablation (CA) eliminated PVC1 at the earliest activation site (EAS), but thereafter another PVC morphology (PVC3) appeared. Small potentials preceding the local potential were broadly exhibited from the RVOT's supero-anterior region to the EAS during PVC3. Point CA targeting such pre-potentials failed. Transverse-linear CA with a line connecting sites with such pre-potentials eliminated both PVCs 3 and 2. In cases with broadly spreading preferential pathways, extensive CA might be needed to eliminate the PVCs.
authors.affiliation: Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital, Tokyo ; Division of Cardiology, Department of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Norishige
authors.initials: N
authors.lastname: Morita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iida
authors.forename: Ueno
authors.initials: U
authors.lastname: Akira
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kobayashi
keywords: Ablation; Pre-potential; Preferential pathway; Premature ventricular contraction; Right Ventricular outflow tract