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A 39-year-old man with idiopathic monomorphic premature ventricular contractions (PVCs), exhibiting a right bundle branch block and inferior axis QRS morphology, underwent electrophysiological testing. After a radiofrequency (RF) application to the anterior mitral annulus (MA) eliminated the spontaneous PVC morphology, a second PVC morphology occurred. Pacing from the first ablation site exhibited an excellent match to the second PVCs with a long stimulus to QRS interval. An RF application delivered near the first lesion eliminated all PVCs. The MA PVCs in this case exhibited a single origin with multiple breakouts and preferential conduction that were unmasked by RF ablation. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.


Takumi Yamada, Harish Doppalapudi, H Thomas McElderry, G Neal Kay. Idiopathic mitral annular PVCs with multiple breakouts and preferential conduction unmasked by radiofrequency catheter ablation. Pacing and clinical electrophysiology : PACE. 2012 May;35(5):e112-5

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PMID: 21091747

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