Journal: Frontiers in Cardiovascular Medicine
Article Title: Premature Ventricular Contractions From the Left Anterior Fascicle: Electrocardiographic and Electrophysiological Characteristics, Mapping Strategy, and Immediate and Long-Term Catheter Ablation Results
doi: 10.3389/fcvm.2022.816237
Figure Lengend Snippet: An example of a failed patient with LAF-PVC who underwent a repeat ablation procedure (patient 22). (A) HV interval during NSR and PVC with mapping electrode positioned at the His bundle was 54 and 10 ms, respectively. (B) The target site was mapped with recordings of local fascicular potential-the onset of the QRS interval of 32 ms during PVC. Three-dimensional activation mapping of the left anterior area showed the target site, and a schematic diagram showed conduction within the Purkinje system. (C) During the repeat procedure, the HV NSR interval was the same as that during the first procedure, while the HV PVC interval was 20 ms; the QRS duration after ablation decreased from 96 to 80 ms, and the axis deviation increased to 21°. Note that NSR-QRS morphology had a slight change, and the QRS duration of PVC was slightly narrower than that before ablation. (D) The same site was identified, and the earliest retrograde PP with 36 ms was mapped and had successful ablation. Three-dimensional activation mapping of the left anterior area showed the target site and a schematic diagram showing the slow conduction within the LAF fiber. It is noted that the target PP was sharp during PVC, while the PP was fragmented during NSR. (E) The electrocardiogram showed the left anterior block after successful ablation. CS, coronary sinus; PP, Purkinje potential; the other abbreviations are as in .
Article Snippet: Left ventricle geometry and activation mapping via a retrograde approach were created by 3-D mapping (CARTO system, Biosense-Webster Inc., Diamond Bar, CA; or EnSite Velocity System, St Jude Medical Inc., St Paul, MN, United States).
Techniques: Activation Assay, Blocking Assay