Radiofrequency catheter ablation of premature ventricular contractions originating from left anterior fascicle

Objective To research the electro-cardiac characteristic of premature ventricular contractions(PVC) originating from left anterior fascicle and the effectiveness of radiofrequency catheter ablation (RFCA).Methods RFCA of frequent PVC originating from left anterior fascicule were performed with 3-dimensional electro anatomic mapping in 6 patients.Results Twelve leads ECG of PVC originating from left anterior fascicle in 6 patients showed right bundle branch block and left posterior fasciuclar block configuration with right-axis deviation.Purkinje potential (PP) were all recorded at the earliest or advancing site of ventricular activation.And PVC in these patients were ablated successfully instandy.During 12 months follow-up period after ablation,PVC disappeared completely in 5 patients,and PVC＜ 1000 beats/24 h in another one.Conclusion The PVC originating from left anterior fascicle in patients without structural heart disease can be successfully ablated at the earliest or advancing site of ventricular activation with PP during both sinus rhythm and PVC.