• Ablation index
• Bipolar radiofrequency ablation
• Interelectrode distance
• Steam pop
• Temperature-controlled ablation
• Transmural lesion

• Advanced ablation strategies
• Bipolar ablation
• Premature ventricular complexes
• Ventricular tachycardia

• Humans
• Male
• Female
• Middle Aged
• Tachycardia, Ventricular/surgery
• Tachycardia, Ventricular/physiopathology
• Ventricular Premature Complexes/surgery
• Ventricular Premature Complexes/physiopathology
• Ventricular Premature Complexes/diagnosis
• Catheter Ablation/methods
• Aged
• Registries
• Recurrence
• Treatment Outcome
• Europe
• Feasibility Studies

• European Heart Rhythm Association Scientific Initiatives Committee
• EHRA-SIC

• Advanced ablation
• Guidelines
• Medical therapy
• Sudden cardiac death
• VT ablation

• Humans
• Workflow
• Tachycardia, Ventricular/diagnosis
• Tachycardia, Ventricular/surgery
• Arrhythmias, Cardiac/surgery
• Treatment Outcome
• Myocardial Ischemia
• Catheter Ablation/methods

• EHRA Scientific Committee and the European Society of Cardiology

• clinical: catheter ablation - ventricular tachycardia
• clinical: electrophysiology - ventricular tachycardia

• Humans
• Tachycardia, Ventricular/diagnosis
• Tachycardia, Ventricular/surgery
• Arrhythmias, Cardiac/diagnosis
• Arrhythmias, Cardiac/surgery
• Ablation Techniques
• Catheter Ablation/adverse effects
• Catheter Ablation/methods

• Catheter ablation
• Innovation
• Stereotactic radiation therapy
• VT mapping
• Ventricular arrhythmia
• Ventricular tachycardia

• Humans
• Tachycardia, Ventricular/therapy
• Arrhythmias, Cardiac/surgery
• Catheter Ablation/methods
• Treatment Outcome

• Bipolar catheter ablation
• Diamond-embedded-tip catheter
• Intramural origin
• Temperature-controlled mode
• Ventricular tachycardia

• Catheter ablation
• His bundle
• Interventricular septum
• Intramural
• Ventricular premature depolarizations

We sought to clarify the electrophysiological (EP) characteristics of premature ventricular contractions (PVCs) with acute successful radiofrequency catheter ablation (RFCA) near the atrioventricular node (AVN).

Eighteen patients with acute successful RFCA near the AVN were included in this study. Systematic mapping was performed with two mapping methods: antegrade mapping technique (group A) and reversed C curve mapping technique (group R). RFCA was preferentially performed underneath the tricuspid valve (TV) with reversed C curve technique in all patients. The a amplitude/v amplitude ratio during sinus rhythm in group A was significantly larger than in group B (0.19 ± 0.10 vs 0.06 ± 0.02, p < 0.01). The earliest bipolar activation preceded the QRS onset in group A was significantly smaller than in group R (19.6 ± 4.9 vs 24.4 ± 6.6 ms (ms), p < 0.01). Pace mapping in group A and group R demonstrated perfect QRS morphology (12/12) match only in 5.6% (one patient) and 16.7% (3 patients) of patients, respectively. The mean duration of successful RFCA was 8.2 ± 2.4 s in 13 patients (72.2%). Early (within 3 days) and late (one-year) recurrence rates were 5.6% (one patient) and 16.7% (3 patients), respectively. No atrioventricular block occurred during RFCA or the one-year follow up.

PVCs near the AVN are a subgroup of idiopathic PVCs with distinctive EP features. RFCA using reversed C curve technique is effective and safe for the acute elimination of these challenging AVN-PVCs.

• Antiarrhythmic drugs
• Catheter ablation
• Implantable cardioverter-defibrillator
• Ischaemic cardiomyopathy
• Sudden cardiac death
• Ventricular tachycardia

Ventricular tachycardia (VT) commonly occurs among patients with heart failure and can even cause sudden cardiac death. VT originating from the His bundle branch has been rarely reported. We present the case of a patient with VT from the His bundle branch.

A 58-year-old female complained of paroxysmal palpitations and dizziness for approximately 6 mo. She had a history of fatty liver and cholecystitis, and carotid atherosclerosis could not be excluded from the ultrasound results. An evaluation of the electrocardiogram obtained after admission showed spontaneous conversion between two different morphologies. The possible electrophysiologic mechanism suggested that the dual-source VT originated from the same source, the His bundle branch. Finally, the His bundle branch was ablated, and a dual-chamber pacemaker was inserted into the patient’s heart. No further VT occurred during the 3-year follow-up after hospital discharge.

The diagnosis of VT originating from the His bundle is rare and difficult to establish. The results of this study showed VT originating from the His bundle based on a careful evaluation of the electrocardiogram, and the diagnosis was confirmed by an intracardiac electrophysiologic examination.

• Electrocardiogram
• His bundle
• Ventricular tachycardia
• Case report

• ablation
• electroanatomical mapping
• electrophysiology
• tachycardia
• ventricular tachycardia

Electrocardiographic and electrophysiological characteristics of VAs originating from the vicinity of the TA are not fully understood. Hence, 104 patients (mean age 52.6 ± 17.9 years; 62 male) with VAs originating from the vicinity of the TA were enrolled. After electrophysiological evaluation and ablation, data were compared among those patients. The ECGs and the correction of the ECGs based on the long axis of the heart calculated from the chest X-Ray were also analyzed. VAs originating from the vicinity of TA had distinctive ECG characteristics that were useful for identifying the precise origin. Our localization algorithm adjusted by the angle between the cardiac long axis and the horizon was found to be accurate in predicting the exact ablation site in 92.3% (n = 96) cases. Logistic regression analysis showed fractionated electrograms, the magnitudes of the local atrial electrograms and a/V ratio were critical factors for successful ablation. Among the 104 patients with VAs, complete elimination could be achieved by RFCA in 96 patients (success rate 92.3%) during a follow-up period of 35.2 ± 19.6 months. This study suggests that the ablation site could be localized by ECG analysis adjusted by the angle between the cardiac long axis and the horizon. Fractionated electrograms, the magnitudes of the local atrial electrograms and a/V ratio were demonstrated to be critical factors for successful ablation.

• catheter ablation
• intramural origin
• radiofrequency ablation
• ventricular arrhythmia

• His bundle
• catheter ablation
• left ventricle
• para-Hisian region
• right ventricle
• ventricular arrhythmias

• bipolar ablation setup
• bipolar radiofrequency catheter ablation
• complications