Key result
Guidewire-assisted ethanol ablation eliminates LAD-adjacent PVCs without causing coronary injury.
Why the study?
PVCs originating from the epicardial anterior interventricular groove adjacent to the LAD are difficult to eliminate and carry high risks of coronary damage or occlusion.
Case Report (n=1)
No
Guidewire-assisted ethanol ablation may serve as an effective and safe alternative for eliminating high-risk epicardial PVCs adjacent to the LAD.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for guidewire-assisted ethanol ablation near LAD; leaves open safety and efficacy in larger cohorts.
BACKGROUND: Premature ventricular complexes (PVCs) originating from epicardial anterior interventricular groove and closely adjacent to the left anterior descending artery (LAD) are difficult to eliminate and carry high risks of coronary damage or occlusion. We describe a successful guidewire-assisted ethanol ablation in this high -risk patient. CASE SUMMARY: A 30-year-old man who presented with palpitations and high-burden PVCs was admitted to our hospital. Pace mapping performed at the epicardial anterior interventricular groove yielded QRS morphology nearly identical to the native PVCs. Coronary angiography revealed that the target site was directly adjacent to the proximal-middle segment of the LAD. Guidewire-assisted ethanol ablation via a small branch of the anterior interventricular vein successfully eliminated the PVCs. Postprocedural coronary angiography showed no coronary artery injury and the patient remained free of PVCs during the 2-month follow-up period. DISCUSSION: Epicardial PVCs arising within the anterior interventricular groove where the LAD runs carry a high risk of coronary artery injury during ablation. Guidewire-assisted anhydrous ethanol ablation serves as an effective and safe therapeutic strategy.
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Guo et al. (2026) conducted a case report in Premature ventricular complexes (PVCs) (n=1). Guidewire-assisted ethanol ablation was evaluated on Elimination of PVCs and absence of coronary artery injury. Guidewire-assisted ethanol ablation successfully eliminated high-burden PVCs originating adjacent to the LAD without causing coronary artery injury during a 2-month follow-up.
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