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Electrocardiographic characteristics and catheter ablation of ventricular ectopic beats originating from junction of left and right coronary sinuses of Valsalva in aorta

ZANG Min-hua1, ZHOU Lei1, MA Jian-wei2, WANG Xin-hua1, HE Ben1   

  1. 1.Department of Cardiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China; 2.Department of Cardiology, Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2013-07-28 Published:2013-08-22
  • Supported by:

    National Key Clinical Discipline Project, 2012

Abstract:

Objective To explore the electrocardiographic characteristics and catheter ablation of ventricular ectopic beats originating from the junction of left and right coronary sinuses of Valsalva in the aorta. Methods Electrocardiographic examination and ablation were performed under the guidance of three dimensional mapping systems in two patients with ectopic beats originating from left ventricular outflow tract. Results Ectopic beats were mapped to originate from the junction of left and right coronary sinuses of Valsalva in both patients. The electrocardiograms showed early precordial transition of QRS complex prior to lead V3 in two patients, the notching QS morphology in lead V1, the qrS pattern in leads V1-V3 in one patient and non-specific morphology in the other patient. Subsequent ablation by positioning the irrigated catheter at the junction of two sinuses of Valsalva or at the left side of the junction (in left coronary sinus of Valsalva) successfully abolished ectopic beats in two patients. Conclusion There may be or may not be characteristic electrocardiographic findings for ventricular ectopic beats originating from the junction of left and right coronary sinuses of Valsalva in the aorta, and catheter ablation could abolish them successfully by proper catheter placement.

Key words: ventricular ectopic beat, sinus of Valsalva, catheter ablation, electrocardiogram