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Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report

BACKGROUND: Ventricular premature complexes (VPCs) occasionally originate from the aortic sinus of Valsalva. Because the anterior part of the left coronary cusp (LCC) and right coronary cusp (RCC) are connected through the ventricular musculature at their bases, VPCs are more common in the LCC and t...

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Autores principales: Tanaka, Atsushi, Nozoe, Masatsugu, Tsutsumi, Takaki, Kubota, Toru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007433/
https://www.ncbi.nlm.nih.gov/pubmed/35434512
http://dx.doi.org/10.1093/ehjcr/ytac129
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author Tanaka, Atsushi
Nozoe, Masatsugu
Tsutsumi, Takaki
Kubota, Toru
author_facet Tanaka, Atsushi
Nozoe, Masatsugu
Tsutsumi, Takaki
Kubota, Toru
author_sort Tanaka, Atsushi
collection PubMed
description BACKGROUND: Ventricular premature complexes (VPCs) occasionally originate from the aortic sinus of Valsalva. Because the anterior part of the left coronary cusp (LCC) and right coronary cusp (RCC) are connected through the ventricular musculature at their bases, VPCs are more common in the LCC and the RCC than in the non-coronary cusp (NCC). We herein report a case in which VPCs were successfully ablated from the NCC, which is considered rare. CASE SUMMARY: A 30-year-old woman was admitted to our hospital for the ablation of VPCs, which comprised 43% of the total heart beats. The clinical VPCs had an inferior axis and left bundle branch block morphology with a precordial transition between V4 and V5. Three-dimensional mapping of the target VPCs indicated that the earliest activation site was RCC. After radiofrequency (RF) energy application at the RCC, VPCs were temporally suppressed but recurred after 24 min. Remapping of the recurrent VPCs revealed that the earliest activation site shifted from the RCC to the His region. To avoid the risk of atrioventricular block, RF energy was applied from the NCC, which resulted in successful elimination of the VPCs without any complications. DISCUSSION: The present case suggests that RF energy application from the NCC may be a safe and effective option for the ablation of VPCs with the earliest activation at the RCC and His region.
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spelling pubmed-90074332022-04-14 Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report Tanaka, Atsushi Nozoe, Masatsugu Tsutsumi, Takaki Kubota, Toru Eur Heart J Case Rep Case Report BACKGROUND: Ventricular premature complexes (VPCs) occasionally originate from the aortic sinus of Valsalva. Because the anterior part of the left coronary cusp (LCC) and right coronary cusp (RCC) are connected through the ventricular musculature at their bases, VPCs are more common in the LCC and the RCC than in the non-coronary cusp (NCC). We herein report a case in which VPCs were successfully ablated from the NCC, which is considered rare. CASE SUMMARY: A 30-year-old woman was admitted to our hospital for the ablation of VPCs, which comprised 43% of the total heart beats. The clinical VPCs had an inferior axis and left bundle branch block morphology with a precordial transition between V4 and V5. Three-dimensional mapping of the target VPCs indicated that the earliest activation site was RCC. After radiofrequency (RF) energy application at the RCC, VPCs were temporally suppressed but recurred after 24 min. Remapping of the recurrent VPCs revealed that the earliest activation site shifted from the RCC to the His region. To avoid the risk of atrioventricular block, RF energy was applied from the NCC, which resulted in successful elimination of the VPCs without any complications. DISCUSSION: The present case suggests that RF energy application from the NCC may be a safe and effective option for the ablation of VPCs with the earliest activation at the RCC and His region. Oxford University Press 2022-03-22 /pmc/articles/PMC9007433/ /pubmed/35434512 http://dx.doi.org/10.1093/ehjcr/ytac129 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Tanaka, Atsushi
Nozoe, Masatsugu
Tsutsumi, Takaki
Kubota, Toru
Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
title Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
title_full Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
title_fullStr Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
title_full_unstemmed Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
title_short Ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
title_sort ventricular premature complexes successfully ablated from the non-coronary cusp: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9007433/
https://www.ncbi.nlm.nih.gov/pubmed/35434512
http://dx.doi.org/10.1093/ehjcr/ytac129
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