Radiofrequency Ablation of Recurrent Ventricular Premature Complex Originating from near Left Ventricular Summit Guided by Intracardiac Echocardiography

ABSTRACT

A 40-year-old man presented with frequent ventricular premature complexes (VPCs) and left ventricular systolic dysfunction. He underwent radiofrequency (RF) ablation using a 3-dimensional mapping system; the ablation was performed from both the right and left outflow tract septa. Improvement in symptoms and left ventricular systolic function was noted, but VPCs recurred one month after the procedure, and 24-hour Holter monitoring revealed a VPC burden of 26%. Direct visualization of the anatomical details, catheter contact, and transmural lesion formation by intracardiac echocardiography allowed for successful performance of a redo RF ablation with higher power and longer duration at the previous ablation sites.