Catheter ablation of premature ventricular contractions originating from the His bundle region

Abstract

We describe a 35-year-old man with idiopathic frequent premature ventricular contractions (PVCs) originating from the His-bundle region, where a low frequency ventricular potential was recorded in the bipolar recording and QR pattern in the unipolar recording. Electro-anatomical mapping revealed a confined low voltage zone (<1.2 mV) in the His-bundle region, and the activation spread out radially to the entire right ventricle. The PVCs were successfully abolished without any atrioventricular block by a step-wise incremental radiofrequency energy application to the His-bundle region. The patient has remained free from PVCs or any symptoms without medication during a 23 month follow-up period.