Arrhythmias & electrophysiologyResearch article
Clinical characteristics of multifocal premature ventricular complexes originating from the basal septal region of the left ventricle: Anatomy, mapping, and ablation
- Patients with multifocal septal premature ventricular complexes (PVCs) who underwent coronary venous mapping were included
Authors' conclusion
Multifocal septal PVCs are consistently associated with abnormalities on electrocardiogram, cardiac magnetic resonance and/or intramural septal electrograms. A stepwise ablation approach substantially reduces PVC burden, although damage to the conduction system remains clinically relevant. The risk of malignant ventricular arrhythmias remains high despite preserved or mildly reduced LV ejection fraction.
Study context
- Population
- Patients with multifocal septal PVCs who underwent coronary venous mappingpatients included
- Participants
- Twenty-four patients
Main finding
As reported in the abstract
PR prolongation of >200 ms
50%
QRS of >100 ms
75%
absent septal R waves
63%
QRS fractionation in inferior leads
38%
Further findings
Left ventricular (LV) ejection fraction
- LV ejection fraction (median)
- 45%
- preserved or mildly reduced
Cardiac magnetic resonance delayed gadolinium enhancement
- delayed gadolinium enhancement
- 71%
Intracardiac echocardiography septal abnormalities
- septal abnormalities
- 83%
Intramural coronary venous mapping
- feasible
- 75%
- intramural activation preceded endocardial activation by
- 10 ms (P < .01)
- fractionated electrograms
Implantable cardioverter-defibrillator
- received an implantable cardioverter-defibrillator
- Thirteen patients (54%)
PVC burden
- PVC burden decreased from
- 18.7% to 2.8% (P < .01)
- ≥80% reduction
- 83%
Appropriate therapies · 1.7 years of follow-up
- patients who received appropriate therapies
- 4 patients (31%)
Original publication
Summarised from the published abstract; every number is checked against it