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Fig. 3 | BMC Cardiovascular Disorders

Fig. 3

From: Approach selection of radiofrequency catheter ablation for ventricular arrhythmias originating from the left ventricular summit: potential relevance of Pseudo Delta wave, Intrinsicoid deflection time, maximal deflection index

Fig. 3

PVCs originating from the left ventricular endocardial summit were ablated by a retrograde transaortic approach. A. PVCs showed the morphology of complete right bundle branch block in precordial leads, with monophasic R wave in leads II, III, aVF, QS in leads aVL and aVR, and rS in lead I. Activation mapping showed that during the sinus rhythm,the earliest ventricular activation of PVCs was recorded in left ventricular endocardial summit and preceded the QRS onset by 42 ms; pacing the site of the earliest ventricular activation resulted in a perfect match to spontaneous PVCs. B. Fluoroscopy of target site. C. Three-dimension mapping of target site. The irrigated-tip ablation catheter was located in the left ventricular endocardial summit, and RF current was delivered with a target temperature of 43 °C and maximum power output of 35 W, flow rate 17 ml/min. The PVCs disappeared after energy application for 3 s, and additional RF current then was applied for another 60s. There was no recurrence during 3.5 years follow-up. Annotation: LAO = left anterior oblique; RAO = Right anterior oblique; ABL = ablation catheter

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BMC Cardiovascular Disorders

ISSN: 1471-2261

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