Intracoronary artery mapping and 3-dimensional visualization of the coronary arteries with a 0.014 inch guidewire in catheter ablation of left ventricular summit premature ventricular contractions

Figures

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  Figure 1. An implantable cardioverter-defibrillator interrogation revealing a ventricular fibrillation triggered by a premature ventricular contraction.

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  Figure 2. Twelve-lead electrocardiograms exhibiting a premature ventricular contraction (PVC; A) and pace maps from the distal left main coronary artery (LMC; B), left coronary cusp (LCC; C), and left ventricular (LV) endocardial site below the LV summit (LV endocardium; D). Note that the pace map from the LMC exhibited a perfect match to the PVC, whereas that from the successful ablation site in the LV endocardium did not.

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  Figure 3. Activation maps exhibiting the anatomical structures such as the left ventricle (LV), great cardiac vein (GCV), anterior interventricular vein (AIV), and left coronary cusp and successful ablation sites (red tags). The earliest ventricular activation (white area) was identified at the GCV-AIV junction near the distal left main coronary artery (LMC). The earliest ventricular activation, preceding the QRS onset by 46 ms, was recoded at the GCV-AIV junction (lower half of image).