Work

PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?

Year: 2021

Type: article

Abstract: A 40 year old man with frequent PVCs with two different morphologies was referred for catheter ablation. Although initial mapping in the RVOT revealed fragmented potentials 20ms earlier than PVC2 onset with a good pace map score, ablation at this site was unsuccessful. Subsequent mapping in the LCC/NCC junction revealed that local ventricular activation preceded QRS onset by 30 and 28 ms for PVC1 and PVC2, respectively. Altering the pacing output at this site produced QRS morphologies similar to PVC1(low output,6mA) and PVC2(high output,15mA) with better pace map scores compared to RVOT. During high-output pacing, there was an increase in stim-QRS latency with decremental conduction. Ablation at this site was successful and suppressed both PVCs.

Source: Indian Pacing and Electrophysiology Journal

DOI: 10.1016/j.ipej.2021.02.008

Authors: Muthiah Subramanian, Sachin Yalagudri, Daljeet Kaur Saggu, Vickram Vignesh Rangaswamy, Calambur Narasimhan

Institution: Asian Institute of Gastroenterology

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: