Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach

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Presentation transcript:

Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach Liliana Tavares, MD, Amish Dave, MD, PhD, Miguel Valderrábano, MD, FACC HeartRhythm Case Reports Volume 4, Issue 8, Pages 371-374 (August 2018) DOI: 10.1016/j.hrcr.2018.05.008 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Patient 1. A: Pace-map correlation maps showing a highest correlation in the proximal coronary sinus (CS; red arrow). B: Signals recorded at the ablation site in sinus. C: Premature ventricular contraction (left panel) and paced QRS from the left ventricle (middle panel) and from the CS (right panel). An average pace-map match of 96% was found while pacing from the CS. D, E: Rhythm strips before and after the procedure, respectively. HeartRhythm Case Reports 2018 4, 371-374DOI: (10.1016/j.hrcr.2018.05.008) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Patient 2. A: Activation maps showing earliest activation time in the proximal coronary sinus (CS). B: Signals recorded at the ablation site in sinus (left panel) and during premature ventricular contraction (right panel). C: Premature ventricular contraction and paced QRS while pacing from the CS. A pace-map match of 98% was found from the CS. D, E: Rhythm strips before and after the procedure, respectively. HeartRhythm Case Reports 2018 4, 371-374DOI: (10.1016/j.hrcr.2018.05.008) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Anatomical relationship between the coronary sinus (CS) and the inferoseptal process (ISP) of the left ventricle (LV). A: Schematic drawing of the heart showing the anatomical relationship between the CS and its adjacent structures. B: Left anterior oblique (LAO) and right anterior oblique (RAO) fluoroscopic views showing the position of the ablation catheter (red arrows) in the proximal CS. C: Intracardiac echocardiography showing the catheter position inside the CS. The ISP of the LV is immediately adjacent to the CS. LVOT = left ventricular outflow tract; MV = mitral valve; RA = right atrium; RVOT = right ventricular outflow tract; TV = tricuspid valve. HeartRhythm Case Reports 2018 4, 371-374DOI: (10.1016/j.hrcr.2018.05.008) Copyright © 2018 Heart Rhythm Society Terms and Conditions