Key result
Pace mapping the right sinus of Valsalva reveals a preferential pathway traversing the ventricular outflow septum.
Case Report (n=1)
This case provides electrophysiological evidence for the existence of a preferential conduction pathway traversing the ventricular outflow septum with different exit sites.
Alerts electrophysiologists to possible multi-exit septal pathways in outflow tract ablation; leaves open need for prospective validation.
A 57-year-old male who presented with frequent ventricular premature contraction (VPC) was referred for catheter ablation. Two different QRS morphologies (VPC1 and VPC2) were recorded. Pace mapping at the right ventricular outflow (RVOT) was identical to VPC1 without latency. During the mapping within the right sinus of Valsalva where the RF applications were successful for elimination of VPC, discrete prepotential was recorded and the pace mapping produced both VPC1 and VPC2 morphology with different latency. These electrophysiological findings were thought to prove the existence of preferential pathway traversing the ventricular outflow septum with different exit sites.
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Shirai et al. (2015) conducted a case report in Frequent ventricular premature contraction (VPC) (n=1). Catheter ablation (RF applications within the right sinus of Valsalva) was evaluated on Elimination of VPC. Pace mapping within the right sinus of Valsalva produced multiple VPC morphologies with different latencies, proving the existence of a preferential pathway traversing the ventricular outflow septum.