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. 2023 Nov 24;5(1):24–33. doi: 10.1016/j.hroo.2023.11.015

Figure 2.

Figure 2

Left ventricular summit premature ventricular complex (PVC) eliminated by bipolar radiofrequency ablation from the left ventricular outflow tract (LVOT) and coronary venous system after failed standard ablation using EnSite (Abbott, St. Paul, MN). Earliest activation was recorded in the great cardiac vein (GCV)/anterior interventricular vein (AIV) junction (–40 ms), whereas the earliest endocardial site was the subaortic LVOT, below the left coronary cusp (–20 ms). Ablation from the GCV/AIV junction was limited by impedance and temperature rise, and ablation from the earliest LVOT site resulted in only transient suppression. One single bipolar radiofrequency application (20 W, 60 s) from LVOT (Abl1; active catheter) to GCV/AIV (Abl2; return catheter) resulted in durable PVC suppression. CS = coronary sinus; ECG = electrocardiogram; LAO = left anterior oblique; RAO = right anterior oblique.