Arrhythmias & electrophysiology
His-LBB Twig: The Origin for Premature Ventricular Complexes With Morphology Almost Identical to Sinus Rhythm
Authors' conclusion
PVC-iSR was caused by a His-LBB twig that could be successfully ablated in or underneath the RCC without injury to the conduction system.
Study context
- Population
- Patients referred for PVC ablation with PVCs of QRS morphology almost identical to sinus rhythm (PVC-iSR)of 3,804 referred for ablation
- Participants
- 20 patients
- Outcome
- Successful ablation of PVC-iSR by targeting the earliest activation site, without AV block or bundle branch block
Main finding
As reported in the abstract
| Group | Value | Ablation site: in the right coronary cusp (RCC) | Ablation site: beneath the RCC | Aborted (high risk of AV nodal injury) |
|---|---|---|---|---|
| PVC-iSR | 17 events | 45% | 40% | 15% |
PVC-iSR
Value17 events
Ablation site: in the right coronary cusp (RCC)45%
Ablation site: beneath the RCC40%
Aborted (high risk of AV nodal injury)15%
- Earliest activation site (EAS) consistently recorded a sharp Purkinje potential; Purkinje-ventricular interval (milliseconds), mean ± SD
- 46.65 ± 4.43
- Distance EAS to left-sided His bundle (mm)
- 8.96 ± 2.32
- Distance EAS to RCC (mm)
- 5.55 ± 2.31
Original publication
His-LBB Twig: The Origin for Premature Ventricular Complexes With Morphology Almost Identical to Sinus Rhythm. JACC Clin Electrophysiol. Published 24 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it