
The study explored premature ventricular contractions (PVCs) originating from the superior septal left ventricle (SSLV) via electrophysiological analysis and radiofrequency catheter ablation (RFCA). Among 247 patients undergoing RFCA for ventricular outflow tract PVCs, 37 achieved successful ablation at SSLV, with 32.4% exhibiting a distinctive spiky potential (SP). These patients displayed PVCs with either narrow (86.8 ± 4.6 ms) or wide QRS (131.6 ± 4.5 ms) durations. Successful RFCA targeted the earliest SP site (local activation time 30 ± 12 ms), significantly differing from non-SP cases (22.1 ± 7.1 ms, P < 0.05). SP presence correlated with PVC morphology, guiding precise ablation strategies.
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