Novel mapping algorithm during catheter ablation for ventricular parasystole originating from left anterior fascicle

• Published in: Journal of arrhythmia Vol. 36; no. 4; pp. 777 - 779
• Main Authors: Kawajiri, Kohei, Kitamura, Takeshi, Hojo, Rintaro, Fukamizu, Seiji
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.08.2020; John Wiley and Sons Inc; Wiley
• Subjects: Ablation; Ablation (Surgery); Algorithms; Cardiac arrhythmia; Case Report; Case Reports; Catheters; Conflicts of interest; Dyspnea; Electrocardiography; fascicle; Health aspects; Mapping; Morphology; Sinuses; three‐dimensional mapping; ventricular arrhythmia; ventricular parasystole; ventricular arrhythmia; fascicle; ventricular parasystole; ablation; three‐dimensional mapping
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12400

A 17‐year‐old woman presented with frequent palpitations and shortness of breath and was diagnosed with drug‐refractory ventricular parasystole. We predicted that the parasystole originated from the left anterior fascicle (LAF). Detailed activation maps of both conduction systems, including the LAF, during sinus rhythm and ventricular parasystole were obtained using a parallel mapping system. We confirmed the earliest fascicular potential of the parasystole and performed catheter ablation with no complications. This novel mapping algorithm for simultaneous acquisition of multiple maps aided effective treatment of ventricular parasystole originating from the LAF. Ventricular parasystole originating from the left anterior fascicle can be effectively eliminated by using this novel mapping algorithm of parallel mapping and LAT hybrid mapping. Parallel mapping makes it possible to obtain both activation maps during ventricular parasystole and sinus rhythm simultaneously, decreasing the procedure time while also increasing efficacy. LAT hybrid mapping also makes it possible for precise positioning during parasystole ablation.