Techniques to Ablate Premature Ventricular Ectopy Arising from the Coronary Sinus System

Frequent ventricular ectopy is often the cause of debilitating symptoms, even in the absence of structural heart disease or malignant ventricular arrhythmias. Mapping and ablation technology has evolved to offer permanent elimination of the ventricular ectopy as a means to manage symptoms. The majority of idiopathic ventricular ectopy originate from the endocardium, but some can only be ablated using an epicardial approach. This paper describes two case reports that highlight some challenges of ablating symptomatic premature ventricular contractions arising from the coronary sinus system (CSS).