Double-exit transaortic sinus cusp ventricular tachycardia: An unusual form of idiopathic outflow tract tachycardia treated by radiofrequency catheter ablation

Idiopathic Mitral Annular PVCs with Multiple Breakouts and Preferential Conduction Unmasked by Radiofrequency Catheter Ablation

“…The electrophysiological features of the LV ostium include preferential conduction, multiple exits, ventricular prepotentials, and a long stimulus‐to‐QRS interval with pacing. These features are more likely to occur with VAs in the aortic root than in the MA 2 , 10–15 . In this case, PVC 1 was eliminated by a single RF application delivered at a site with earliest ventricular activation in the anterior aspect of the MA, where there was not an excellent pace map.…”

Idiopathic Premature Ventricular Contractions Exhibiting Preferential Conduction within the Aortic Root

“…[7][8][9][10][11] Several reports have suggested various types of myocardial fibers associated with preferential conduction in the LV ostium. [7][8][9][10][11] This case is unique when compared with the previous reports 7-11 for several reasons. First, both the PVC origin that was ablated in the LCC and breakout site in the RCC were located within the aortic root.…”

“…6,7 Preferential conduction of those VAs has been demonstrated to range between the different sites in the LV ostium and RVOT. [7][8][9][10][11] We report a case with idiopathic premature ventricular contractions (PVCs) exhibiting preferential conduction within the aortic root.…”

Catheter Ablation of Premature Ventricular Contractions Originating in the Aortic Sinus Cusp or Great Cardiac Vein: Two QRS Morphologies with One Origin

“…In another case report, VT originated from the aortic sinus cusp having two morphologies. This report first described a successful ablation of both VTs from the same site and considered a “double exit” reentry mechanism . All 10 patients in our study showed two QRS morphologies and a final successful ablation site in ASC or GCV.…”

“…Idiopathic VT with more than one QRS morphology in the same patient arising from the ASC has been described in a small series of patients . In a previous report of six patients, tachycardia changed the QRS morphology following ablation, requiring an additional ablation application to the outflow tract at a different portion .…”