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Updated: Jun 13, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
06:57

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

[Radiofrequency ablation of ventricular arrhythmia from the non-coronary cusp]

Michał Orczykowski1, Lukasz Szumowski, Paweł Derejko

  • 1Klinika Zaburzeń Tytmu Serca, Instytut Kardiologii, Warszawa-Anin.

Kardiologia Polska
|April 29, 2010
PubMed

Insights

Frequent premature ventricular beats can originate near the His bundle. Ablation from the non-coronary aortic cusp (NCC) was successful, even though the electrogram preceded the QRS. Mapping the NCC is crucial for identifying arrhythmia origins near the His bundle.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Anatomy

Background:

  • The His bundle (HB) in the right ventricle (RV) is anatomically close to the non-coronary aortic cusp (NCC).
  • Premature ventricular beats (PVBs) can originate from various cardiac locations.
  • Identifying the precise origin of PVBs is critical for effective treatment.

Observation:

  • A patient presented with frequent PVBs originating near the His bundle (HB) region.
  • Local electrograms in the NCC preceded the QRS complex in both the NCC and His area.
  • Radiofrequency ablation targeting the NCC successfully eliminated the PVBs.

Findings:

  • The non-coronary aortic cusp (NCC) can be a source of premature ventricular beats (PVBs) originating near the His bundle (HB).
  • Electrophysiological mapping demonstrating early activation in the NCC, preceding the QRS, is indicative of an arrhythmogenic focus in this region.
  • Successful ablation from the NCC highlights its potential as a target for ventricular arrhythmia treatment.

Implications:

  • RV mapping for arrhythmias near the HB should include assessment of the right coronary cusp and NCC.
  • This approach can improve the success rate of ablation for complex ventricular arrhythmias.
  • Understanding the anatomical relationship between the aortic cusps and the His bundle is vital for electrophysiologists.

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