Recurrence of RVOT PVCs with a Marked Shift of Its Exit Point. Gradual Elimination of Arrhythmogenic Focus by Multisite Approach

We present a case of recurrent outflow tract arrhythmia despite repeated ablations. Premature ventricular contractions (PVCs) morphology suggested a right‐sided focus. However, electrograms preceding PVCs were recorded from the right and left outflow tracts, distal coronary sinus, and right sinus of...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2012-01, Vol.35 (1), p.e6-e9
Main Authors: DEREJKO, PAWEŁ, ORCZYKOWSKI, MICHAŁ, SZUMOWSKI, ŁUKASZ J., WALCZAK, FRANCISZEK
Format: Article
Language:English
Subjects:
Adult
Heart Conduction System - surgery
Humans
Male
outflow tract arrhythmia
Recurrence
RF ablation
Treatment Outcome
Ventricular Premature Complexes - diagnosis
Ventricular Premature Complexes - prevention & control
Ventricular Premature Complexes - surgery
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Summary:We present a case of recurrent outflow tract arrhythmia despite repeated ablations. Premature ventricular contractions (PVCs) morphology suggested a right‐sided focus. However, electrograms preceding PVCs were recorded from the right and left outflow tracts, distal coronary sinus, and right sinus of Valsalva. Arrhythmia was eliminated after radiofrequency (RF) applications delivered from different sites. We conclude that, in patients with recurrent outflow tract PVCs, mapping all the sites mentioned above may be necessary to find the earliest activation site and carry out successful ablation. In some patients, RF applications from multiple sites may be necessary to completely eliminate arrhythmia. (PACE 2012; 35:e6–e9)
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.2010.02861.x