Premium
Premature Ventricular Contractions with a Right Bundle Branch Block and Inferior QRS Axis Morphology: Where is the Site of the Origin?
Author(s) -
YAMADA TAKUMI,
HUIZAR JOSE F.,
McELDERRY HUGH T.,
KAY G. NEAL
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00800.x
Subject(s) - medicine , cardiology , qrs complex , ventricular outflow tract , cusp (singularity) , t wave , left bundle branch block , right bundle branch block , bigeminy , electrocardiography , ventricular tachycardia , geometry , heart failure , mathematics
A 63‐year‐old woman with symptomatic premature ventricular contractions (PVCs) underwent electrophysiologic testing. The PVCs were suggested to originate from the infra‐aortic valvular left ventricular outflow tract because the PVCs had S‐waves in leads I, V5, and V6, and an R/S ratio >1 in lead V 1 . However, during some PVCs without S‐waves, the ST segment had negative retrograde P‐waves with a longer ventricularatrial (VA) interval. A Radiofrequency (RF) application in the left coronary cusp completely eliminated the PVCs, suggesting that negative retrograde P‐waves might have been observed as pseudo S‐waves during the PVCs.