The left ventricular summit (LVS) is a challenging location for catheter‐based percutaneous ablation due to its anatomical location. There have been case reports of cryoablations performed in this region, but the technique may be underutilized when radiofrequency ablation fails. A 45‐year‐old male was found to have 25 000 premature ventricular contractions (PVCs) a day despite previous ablation and a reduced ejection fraction of 40% despite medical therapy. Coronary sinus epicardial mapping revealed the coronary sinus distal region generated activations earlier than the QRS onset by 28 ms. Two separate, 4‐minute cryoablations were delivered that suppressed the PVCs within 5 seconds. Alternate energy modalities such as cryo may offer a safer and more viable approach for ablation of LVS in select patients.

中文翻译：

---

通过冠状窦成功冷冻消融左心室顶点室性早搏。

由于其解剖位置，左心室顶点 (LVS) 是基于导管的经皮消融术的一个具有挑战性的位置。已有在该地区进行冷冻消融的病例报告，但当射频消融失败时，该技术可能未得到充分利用。一名 45 岁男性被发现尽管之前进行了消融，但每天仍有 25 000 次室性早搏 (PVC)，尽管接受了药物治疗，但射血分数仍降低了 40%。冠状窦心外膜标测显示冠状窦远端区域比 QRS 发作早 28 毫秒产生激活。两次单独的 4 分钟冷冻消融术在 5 秒内抑制了 PVC。替代能源模式（例如冷冻）可能为特定患者的 LVS 消融提供更安全、更可行的方法。