Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Dec;41(12):766-9.
doi: 10.4070/kcj.2011.41.12.766. Epub 2011 Dec 31.

Catheter ablation of parahisian premature ventricular complex

Jun Kim  1 , Jeong Su Kim, Yong Hyun Park, June Hong Kim, Kook Jin Chun
Affiliations

Catheter ablation of parahisian premature ventricular complex

Jun Kim et al. Korean Circ J. 2011 Dec.

Abstract

Catheter ablation is performed in selected patients with a symptomatic premature ventricular complex (PVC) or PVC-induced cardiomyopathy. Ablation of PVC from the His region has a high risk of inducing a complete atrioventricular block. Here we report successful catheter ablation of a parahisian PVC in a 63-year-old man.

Keywords: Bundle of His; Catheter ablation; Premature ventricular complexes.

PubMed Disclaimer

Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
A 12-lead electrocardiogram of the patient (A). Premature ventricular complex in bigeminal pattern is shown. Surface electrocardiogram I, II, V 1, V6 together with intracardiac electrograms from the proximal and distal bipolar electrograms in the His region (HIp HIS d) are displayed from top to bottom (B). Local ventricular activation in the His recording area is earlier than onset of PVC by 18 ms.
Fig. 2
Fig. 2
Surface electrocardiogram I, II, V 1, V6 together with intracardiac electrograms from the proximal and distal bipolar electrograms in the His region (HIp HIS d) and proximal, distal bipolar and unipolar electrogram andablation catheter (ABLp, ABLd and ABLuni) are displayed from top to bottom. Local ventricular activation was earlier at the unsuccessful ablation site than the onset of PVC by 24 ms (A). Right anterior oblique (RAO) and left anterior oblique (LaO) fluoroscopic views of unsuccessful ablation site. Ablation catheter (ABL) is located a few millimeter anterior and inferior to the His recording catheter (HIS) (B and C). Also shown is a catheter in the right ventricular apex (RVA). Local ventricular activation was earliest at the successful ablation site than the onset of PVC by 35 ms (D). RAO and LAO fluoroscopic views of successful ablation site (E and F). Compared with B and C, ablation catheter (ABL) is located a few millimeter anterior and superior to the His recording catheter (HIS).
Fig. 3
Fig. 3
A 12-lead electrocardiogram during application of radiofrequency energy. After application of RF energy there was immediate disappearance of premature ventricular complex.
Fig. 4
Fig. 4
Pacemapping at the successful ablation site. Morphology of QRS complex during pacing by ablation catheter at the ablation site is same with morphology of PVC in all 12 leads.
See this image and copyright information in PMC

References

    1. Zhu DW, Maloney JD, Simmons TW, et al. Radiofrequency catheter ablation for management of symptomatic ventricular ectopic activity. J Am Coll Cardiol. 1995;26:843–849. - PubMed
    1. Seidl K, Schumacher B, Hauer B, et al. Radiofrequency catheter ablation of frequent monomorphic ventricular ectopic activity. J Cardiovasc Electrophysiol. 1999;10:924–934. - PubMed
    1. Takemoto M, Yoshimura H, Ohba Y, et al. Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease. J Am Coll Cardiol. 2005;45:1259–1265. - PubMed
    1. Yarlagadda RK, Iwai S, Stein KM, et al. Reversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract. Circulation. 2005;112:1092–1097. - PubMed
    1. Bogun F, Crawford T, Reich S, et al. Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: comparison with a control group without intervention. Heart Rhythm. 2007;4:863–867. - PubMed