Key result
Left para-Hisian PVC ablation cuts burden below 5% but causes complete AV block requiring pacing.
Why the study?
Catheter ablation of left para-Hisian PVCs is challenging due to high risk of inadvertent AV block and lower long-term success rates, requiring careful preprocedural planning.
Case Report (n=1)
Catheter ablation of left para-Hisian PVCs can successfully reduce arrhythmia burden and improve left ventricular function, but carries a high risk of inadvertent complete AV block requiring permanent pacing.
Answers are grounded in this paper and cite their sources.
Risk of AV block warrants caution in left para-Hisian PVC ablation; leaves open safer mapping or energy strategies.
Background: Our case highlights the challenging nature of left para-Hisian premature ventricular contractions (PVCs) catheter ablation (CA) and proves that sometimes the compromise between successful ablation and inadvertent atrioventricular (AV) block is the only viable solution for the patient. Case presentation:The case shows an improvement of left ventricular function combining heart failure therapy and CA of the PVC.However, a complete AV block-although with a junctional escape rhythm-could not be avoided. Conclusions:The main "take-away" lesson from this case is the importance of prediction of PVC site of origin during preprocedural planning.This is helpful to plan the anatomical approach required for mapping and ablation of these PVCs and to appreciate the risk of the procedure.
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Gaitan et al. (2026) conducted a case report in Left para-Hisian premature ventricular contractions (n=1). Radiofrequency catheter ablation was evaluated.
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