Key result
Radiofrequency ablation at the RCC-LCC commissure successfully eliminated both PVCs and late potentials, suggesting possible bidirectional conduction of insulated myocardial pathways.
Why the study?
Does radiofrequency ablation at the RCC-LCC commissure eliminate PVCs and late potentials in patients with insulated myocardial pathways?
Case Report
Does radiofrequency ablation at the RCC-LCC commissure eliminate PVCs and late potentials in patients with insulated myocardial pathways?
Ablation at the RCC-LCC commissure may eliminate PVCs with late potentials; leaves open bidirectional conduction via insulated myocardial pathways.
Key Teaching Points•An insulated myocardial pathway, which is a pathway potential connected to the exit, is sometimes observed as a fractionated presystolic potential preceding the QRS onset during premature ventricular contractions (PVCs).•The insulated myocardial pathway can be characterized by the coexistence of a fractionated presystolic potential and a late potential, both originating from the right coronary cusp–left coronary cusp (RCC–LCC) commissure.•Radiofrequency ablation at the RCC–LCC commissure can successfully eliminate both the PVCs and late potentials in such cases.•These findings suggest a possible bidirectional conduction of the insulated myocardial pathways. •An insulated myocardial pathway, which is a pathway potential connected to the exit, is sometimes observed as a fractionated presystolic potential preceding the QRS onset during premature ventricular contractions (PVCs).•The insulated myocardial pathway can be characterized by the coexistence of a fractionated presystolic potential and a late potential, both originating from the right coronary cusp–left coronary cusp (RCC–LCC) commissure.•Radiofrequency ablation at the RCC–LCC commissure can successfully eliminate both the PVCs and late potentials in such cases.•These findings suggest a possible bidirectional conduction of the insulated myocardial pathways.
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Yagyu et al. (2018) conducted a case report in Premature ventricular contractions. Radiofrequency ablation at the RCC-LCC commissure was evaluated on Elimination of PVCs and late potentials. Radiofrequency ablation at the RCC-LCC commissure successfully eliminated both PVCs and late potentials, suggesting possible bidirectional conduction of insulated myocardial pathways.
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