A 38-year-old woman with a structurally normal heart was referred for catheter ablation due to symptomatic, monomorphic, high burden (12%) premature ventricular complexes (PVC) refractory to medical therapy. The PVC's ECG morphology suggested an origin in the proximal left anterior fascicle (LAF). During procedure PVCs were mechanically suppressed. Consequently, selection of the ablation target site was based on pace-mapping. This case illustrates how ablation from the right coronary cusp (RCC) for PVC arising from the proximal LAF could be accurately guided by pace-mapping. At this location, pacing can result in both a selective and a non-selective capture of the proximal LAF.

一名心脏结构正常的 38 岁女性因药物治疗无效的症状性、单形性、高负担 (12%) 室性早搏 (PVC) 而被转诊进行导管消融。PVC 的 ECG 形态表明起源于近端左前束 (LAF)。在手术过程中，PVC 被机械抑制。因此，消融目标部位的选择基于起搏映射。这个案例说明了如何通过起搏映射准确地引导来自近端 LAF 的 PVC 的右冠状动脉尖 (RCC) 消融。在这个位置，起搏可以导致近端 LAF 的选择性和非选择性捕获。