1. Successful Transseptal Catheter Ablation of Premature Ventricular Contractions Arising from the Mitral Annulus: A Case with a Pure Annular Origin
- Author
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G. Neal Kay, Takumi Yamada, Andrew E. Epstein, Vance J. Plumb, J. Scott Allison, Harish Doppalapudi, and H. Thomas McElderry
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Transseptal catheter ,Catheter ablation ,Great cardiac vein ,Heart Conduction System ,Internal medicine ,Mitral valve ,Heart Septum ,medicine ,Humans ,cardiovascular diseases ,Mitral annulus ,Coronary sinus ,business.industry ,General Medicine ,Right bundle branch block ,medicine.disease ,Ablation ,Ventricular Premature Complexes ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Catheter Ablation ,cardiovascular system ,Cardiology ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
A 74-year-old man with symptomatic premature ventricular contractions (PVCs) with a right bundle branch block and right inferior axis QRS morphology underwent electrophysiologic testing. During the PVCs, coronary sinus mapping revealed ventricular prepotentials with the earliest activation in the distal great cardiac vein (GCV) where the local ventricular electrograms were smaller in amplitude than the atrial electrograms. The transaortic approach could not reach the earliest activation site within the GCV, but the transseptal catheter ablation successfully eliminated the PVCs on the mitral valve. With catheter ablation of ventricular arrhythmias with pure mitral annular origins, a transseptal approach may be necessary.
- Published
- 2009