Narrow QRS ectopy with concealed connections from a para‐Hisian origin to the proximal left fascicles

Author:

Nakamura Kohki1ORCID,Sasaki Takehito1,Minami Kentaro2ORCID,Aoki Hideyuki1,Yoshimura Shingo1ORCID,Nishiuchi Suguru3ORCID,Naito Shigeto1

Affiliation:

1. Division of Cardiology, Gunma Prefectural Cardiovascular Center Maebashi City Gunma Japan

2. Department of Cardiovascular Medicine Dokkyo Medical University Mibu Tochigi Japan

3. Department of Cardiology Tenri Hospital Tenri City Nara Japan

Abstract

AbstractIntroductionCatheter ablation of ectopy originating from the vicinity of the His bundle can be challenging.Methods and ResultsWe report a case of a 33‐year‐old man with narrow QRS ectopy with preferential conduction from a para‐Hisian origin to the proximal left fascicles, which was successfully eliminated by radiofrequency ablation in the right coronary cusp, guided by ultrahigh‐resolution mapping of the His bundle, bundle branch, and fascicular electrograms.ConclusionSome narrow QRS ectopy may originate from the vicinity of the conduction system, instead of the “true” conduction system, and have concealed connections from its origin to the conduction system.

Publisher

Wiley

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