JACC. Case reports · 2026
Successful Guidewire-Guided Ethanol Ablation for PVCs Originating From Epicardial Anterior Interventricular Groove Adjacent to LAD.
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Guo Caihong, Xiong Xiong, Yi Hongwei, Yang Yujing, Han Caiping, Deng Chenggang, Zhang Jinlin
Аннотация
BACKGROUND: Premature ventricular complexes (PVCs) originating from epicardial anterior interventricular groove and closely adjacent to the left anterior descending artery (LAD) are difficult to eliminate and carry high risks of coronary damage or occlusion. We describe a successful guidewire-assisted ethanol ablation in this high -risk patient.
CASE SUMMARY: A 30-year-old man who presented with palpitations and high-burden PVCs was admitted to our hospital. Pace mapping performed at the epicardial anterior interventricular groove yielded QRS morphology nearly identical to the native PVCs. Coronary angiography revealed that the target site was directly adjacent to the proximal-middle segment of the LAD. Guidewire-assisted ethanol ablation via a small branch of the anterior interventricular vein successfully eliminated the PVCs. Postprocedural coronary angiography showed no coronary artery injury and the patient remained free of PVCs during the 2-month follow-up period.
DISCUSSION: Epicardial PVCs arising within the anterior interventricular groove where the LAD runs carry a high risk of coronary artery injury during ablation. Guidewire-assisted anhydrous ethanol ablation serves as an effective and safe therapeutic strategy.
CASE SUMMARY: A 30-year-old man who presented with palpitations and high-burden PVCs was admitted to our hospital. Pace mapping performed at the epicardial anterior interventricular groove yielded QRS morphology nearly identical to the native PVCs. Coronary angiography revealed that the target site was directly adjacent to the proximal-middle segment of the LAD. Guidewire-assisted ethanol ablation via a small branch of the anterior interventricular vein successfully eliminated the PVCs. Postprocedural coronary angiography showed no coronary artery injury and the patient remained free of PVCs during the 2-month follow-up period.
DISCUSSION: Epicardial PVCs arising within the anterior interventricular groove where the LAD runs carry a high risk of coronary artery injury during ablation. Guidewire-assisted anhydrous ethanol ablation serves as an effective and safe therapeutic strategy.