PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?

A 40 year old man with frequent PVCs with two different morphologies was referred for catheter ablation. Although initial mapping in the RVOT revealed fragmented potentials 20ms earlier than PVC2 onset with a good pace map score, ablation at this site was unsuccessful. Subsequent mapping in the LCC/...

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Autores principales: Subramanian, Muthiah, Yalagudri, Sachin, Saggu, Daljeet Kaur, Vignesh Rangaswamy, Vickram, Narasimhan, Calambur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116814/
https://www.ncbi.nlm.nih.gov/pubmed/33609666
http://dx.doi.org/10.1016/j.ipej.2021.02.008
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author Subramanian, Muthiah
Yalagudri, Sachin
Saggu, Daljeet Kaur
Vignesh Rangaswamy, Vickram
Narasimhan, Calambur
author_facet Subramanian, Muthiah
Yalagudri, Sachin
Saggu, Daljeet Kaur
Vignesh Rangaswamy, Vickram
Narasimhan, Calambur
author_sort Subramanian, Muthiah
collection PubMed
description A 40 year old man with frequent PVCs with two different morphologies was referred for catheter ablation. Although initial mapping in the RVOT revealed fragmented potentials 20ms earlier than PVC2 onset with a good pace map score, ablation at this site was unsuccessful. Subsequent mapping in the LCC/NCC junction revealed that local ventricular activation preceded QRS onset by 30 and 28 ms for PVC1 and PVC2, respectively. Altering the pacing output at this site produced QRS morphologies similar to PVC1(low output,6mA) and PVC2(high output,15mA) with better pace map scores compared to RVOT. During high-output pacing, there was an increase in stim-QRS latency with decremental conduction. Ablation at this site was successful and suppressed both PVCs.
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spelling pubmed-81168142021-05-18 PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism? Subramanian, Muthiah Yalagudri, Sachin Saggu, Daljeet Kaur Vignesh Rangaswamy, Vickram Narasimhan, Calambur Indian Pacing Electrophysiol J Case Report A 40 year old man with frequent PVCs with two different morphologies was referred for catheter ablation. Although initial mapping in the RVOT revealed fragmented potentials 20ms earlier than PVC2 onset with a good pace map score, ablation at this site was unsuccessful. Subsequent mapping in the LCC/NCC junction revealed that local ventricular activation preceded QRS onset by 30 and 28 ms for PVC1 and PVC2, respectively. Altering the pacing output at this site produced QRS morphologies similar to PVC1(low output,6mA) and PVC2(high output,15mA) with better pace map scores compared to RVOT. During high-output pacing, there was an increase in stim-QRS latency with decremental conduction. Ablation at this site was successful and suppressed both PVCs. Elsevier 2021-02-18 /pmc/articles/PMC8116814/ /pubmed/33609666 http://dx.doi.org/10.1016/j.ipej.2021.02.008 Text en © 2021 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Subramanian, Muthiah
Yalagudri, Sachin
Saggu, Daljeet Kaur
Vignesh Rangaswamy, Vickram
Narasimhan, Calambur
PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?
title PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?
title_full PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?
title_fullStr PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?
title_full_unstemmed PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?
title_short PVCs with multiple exits and single site of origin in the outflow tract: What is the mechanism?
title_sort pvcs with multiple exits and single site of origin in the outflow tract: what is the mechanism?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116814/
https://www.ncbi.nlm.nih.gov/pubmed/33609666
http://dx.doi.org/10.1016/j.ipej.2021.02.008
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