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Fig. 4 | BMC Cardiovascular Disorders

Fig. 4

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. 4

PVCs originating from left ventricular epicardial summit were ablated by an antegrade DCGV approach. a. PVCs showed the morphology of complete right bundle branch block, with precordial transition zone before V1, monophasic R in leads II, III, aVF and V3-6, RIII > RII, QS in leads aVL and aVR, QSaVL > QSaVR, rS in lead I. b. The irrigated-tip ablation catheter was delivered to the DCGV via the coronary sinus for mapping and ablation, the earliest ventricular activation of PVCs were recorded in the left ventricular epicardial summit preceding the QRS wave onset by 37 ms. c. Pacing the site of the earliest ventricular activation yielded a perfect match to spontaneous PVCs. d. Fluoroscopy of target site. e. Three-dimension mapping of target site. The ablation catheter was located in the left ventricular epicardial summit, and irrigated RF current was delivered with a target temperature of 43 °C, maximum power output of 25 W, and flow rate of 30 ml/min. The PVCs disappeared after energy delivery for 6 s; additional RF current then was applied for another 60s. There was no recurrence during 0.5 years follow-up

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BMC Cardiovascular Disorders

ISSN: 1471-2261

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