Mapping and ablation strategy for idiopathic premature ventricular contraction originating in the vicinity of left ventricular summit

Objective To evaluate the mapping and ablation strategy of idiopathic premature ventricular contraction (PVC) originating in the vicinity of left ventricular summit (LVS) . Methods Fifty-nine patients with idiopathic PVC originating in the vicinity of LVS accepting electrophysiological study and ablation were enrolled. Results The patients were classified into 2 groups. Group A included 38 patients in whom the earliest activation sites during PVC were in the coronary venous system, and PVC were successfully eliminated in 35 cases at the adjacent anatomic sites including the aortic root, the endocardium underneath the aortic valve, and the aortomitral continuity. Group B included 21 patients in whom the earliest activation sites were located in other parts of the out flow tracts. The PVCs were successfully eliminated in 19 cases including bipolar ablation in 3 cases. During the follow up period of (37.4±14.8) months, the total successful rate of one procedure was 91.5%. Conclusion An anatomic approach and a reasonable mapping strategy are warranted for ablating the PVC originating in the vicinity of LVS. Key words: Premature ventricular contraction; Catheter ablation