PMC4440798_01
PVCs of Patient 1 recorded in the EP laboratory. (Left panel: PVC 1; Right panel: PVC 2)
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F1
At EP study, two PVCs were noted (Supplemental figure 1).
Activation and pacemapping of PVCs in Case 1. Left panel: Intracardiac electrogram near ablation site shows a pre-potential (marked by red arrow) between the breakout sites of both PVCs, and was 95 ms ahead of the surface QRS. The ventricular electrogram was 20 ms after the onset of the surface QRS.. Right panel: Pacemapping at the site of ablation with low output capture reproduced both PVC morphologies.
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F2
One of the PVCs had earliest activation on the posterior proximal RVOT and was at the base of the conus papillary muscle visualized with ICE (Supplemental Figure 2).
Ablation catheter at the ablation site in Case 1. (Left: LAO view; Right: RAO view)
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F3
Fluoroscopy (Figure 3) and ICE imaging (Figure 4) showed that the mapping catheter was positioned on the mid-portion of the conus papillary muscle.
Conus Papillary Muscle was the site of PVC ablation. Left panel is an illustration showing correlative structures seen on the ICE image (right panel). The body of the conus papillary muscle is marked with an asterisk in both images. The body of the conus papillary muscle is seen with an attached tendinous chord (marked by arrow) that is part of the tricuspid valve (TV).
nihms-678284-f0004.jpg
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F4
Fluoroscopy (Figure 3) and ICE imaging (Figure 4) showed that the mapping catheter was positioned on the mid-portion of the conus papillary muscle.
PMC4440798_02
PVCs of Patient 1 recorded in the EP laboratory. (Left panel: PVC 1; Right panel: PVC 2)
nihms-678284-f0001.jpg
PMC4440798_02_nihms-678284-f0001.jpg
F1
At EP study, two PVCs were noted (Supplemental figure 1).
PMC4440798_03
Activation and pacemapping of PVCs in Case 1. Left panel: Intracardiac electrogram near ablation site shows a pre-potential (marked by red arrow) between the breakout sites of both PVCs, and was 95 ms ahead of the surface QRS. The ventricular electrogram was 20 ms after the onset of the surface QRS.. Right panel: Pacemapping at the site of ablation with low output capture reproduced both PVC morphologies.
nihms-678284-f0002.jpg
PMC4440798_03_nihms-678284-f0002.jpg
F2
One of the PVCs had earliest activation on the posterior proximal RVOT and was at the base of the conus papillary muscle visualized with ICE (Supplemental Figure 2).