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Distinct Electrocardiographic Form of Idiopathic Ventricular Arrhythmia Originating From the Left Bundle Branch

Rajeev K Pathak1, Brian P Betensky1, Pasquale Santangeli1

  • 1Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Journal of Cardiovascular Electrophysiology
|August 30, 2016
PubMed

Insights

Idiopathic frequent premature ventricular contractions (PVCs) can originate from the left bundle branch. Radiofrequency ablation successfully treated these challenging arrhythmias without impacting heart conduction.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Anatomy

Background:

  • Premature ventricular contractions (PVCs) commonly originate from the ventricular outflow tracts.
  • While some PVCs arise near the His-bundle, origins within the cardiac conduction system are poorly understood.

Observation:

  • This study details two cases of idiopathic frequent PVCs mapped directly to the left bundle branch.
  • Anatomical mapping identified the left bundle branch as the ectopic source.

Findings:

  • Radiofrequency ablation at the left bundle branch successfully eliminated or suppressed the PVCs.
  • The ablation procedure did not cause significant impairment of atrioventricular conduction.

Implications:

  • This approach offers a potential management strategy for challenging PVCs originating from the cardiac conduction system.
  • Understanding these specific PVC origins can improve ablation success rates and patient outcomes.

Keywords:
His-Purkinje systemidiopathic ventricular arrhythmialeft bundle branchpara-Hisianpremature ventricular contraction

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