{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:34Z","timestamp":1753876174792,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Zhongnanshan Medical Foundation of Guangdong Province","award":["202151"],"award-info":[{"award-number":["202151"]}]},{"name":"Guangdong Special Funds for Science and Technology Innovation Strategy, China","award":["KJ022021050"],"award-info":[{"award-number":["KJ022021050"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Previously, ablation at the outflow tract was considered to be safe and rarely affected the His\u2013Purkinje system due to their spatial distance. However, we have reported a case of right bundle branch block (RBBB) and junctional beats that were recorded during radiofrequency catheter ablation in a patient who had a history of peri-membranous ventricular septal defect (pmVSD) closure and the implantation of a metallic occluder.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 16-year-old girl with a metallic occluder for peri-membranous ventricular septum defect underwent an ablation procedure for premature ventricular complexes. During the ablation at the right ventricular outflow tract (RVOT), RBBB and junctional beats were recorded. His bundle potentials and the high-frequency potential generated by electrical interference were observed when mapping the margin of the occluder. To ensure safety, we attempted ablation at the right coronary cusp in the left ventricular outflow tract, which eventually proved to be successful, presenting an alternative ablation strategy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This is a rare report of RBBB and junctional beats observed during ablation at RVOT in a patient with pmVSD and a metallic occluder. The observed damage to the His\u2013Purkinje system may be attributed to uncontrolled radiofrequency energy heating up caused by the metallic device. This case emphasizes the importance of thorough electroanatomic and activation mapping prior to starting the ablation procedure, especially in complicated cases. Furthermore, it suggests that ablation at a relatively remote position is both feasible and relatively safe for patients with occluder devices.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae054","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T07:56:33Z","timestamp":1706774193000},"source":"Crossref","is-referenced-by-count":1,"title":["A case report of right bundle branch block and junctional beats during ablation at the right ventricle outflow tract: metallic occluder\u2019s unanticipated effect"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0584-710X","authenticated-orcid":false,"given":"Sijia","family":"Pu","sequence":"first","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University , 106 Zhongshan Er Rd , Guangzhou 510080, China"},{"name":"School of Medicine, South China University of Technology , Guangzhou 510006 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University , 106 Zhongshan Er Rd , Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Deng","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University , 106 Zhongshan Er Rd , Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7354-0014","authenticated-orcid":false,"given":"Yumei","family":"Xue","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University , 106 Zhongshan Er Rd , Guangzhou 510080, China"},{"name":"School of Medicine, South China University of Technology , Guangzhou 510006 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2526-7695","authenticated-orcid":false,"given":"Weidong","family":"Lin","sequence":"additional","affiliation":[{"name":"Guangdong Cardiovascular Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University , 106 Zhongshan Er Rd , Guangzhou 510080, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"2024021514582886200_ytae054-B1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijcard.2017.12.011","article-title":"A meta-analysis of transcatheter device closure of perimembranous ventricular septal defect","volume":"254","author":"Santhanam","year":"2018","journal-title":"Int J Cardiol"},{"key":"2024021514582886200_ytae054-B2","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jcin.2012.01.015","article-title":"Risk factors and outcomes of post-procedure heart blocks after transcatheter device closure of perimembranous ventricular septal defect","volume":"5","author":"Yang","year":"2012","journal-title":"JACC Cardiovasc Interv"},{"key":"2024021514582886200_ytae054-B3","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.ccep.2017.02.001","article-title":"Introduction to the congenital heart defects: anatomy of the conduction system","volume":"9","author":"Moore","year":"2017","journal-title":"Card Electrophysiol"},{"key":"2024021514582886200_ytae054-B4","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1253\/circj.CJ-19-0664","article-title":"Novel strategy for predicting conduction abnormalities during transcatheter closure of perimembranous ventricular septal defect in adults","volume":"84","author":"Tang","year":"2020","journal-title":"Circ J"},{"key":"2024021514582886200_ytae054-B5","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/j.hrthm.2015.05.011","article-title":"Effect of radiofrequency energy delivery in proximity to metallic medical device components","volume":"12","author":"Nguyen","year":"2015","journal-title":"Heart Rhythm"},{"key":"2024021514582886200_ytae054-B6","doi-asserted-by":"crossref","first-page":"e008173","DOI":"10.1161\/CIRCEP.119.008173","article-title":"Ablation at right coronary cusp as an alternative and favorable approach to eliminate premature ventricular complexes originating from the proximal left anterior fascicle","volume":"13","author":"Chen","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae054\/56527919\/ytae054.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/2\/ytae054\/56671229\/ytae054.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/2\/ytae054\/56671229\/ytae054.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T14:58:45Z","timestamp":1708009125000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae054\/7595528"}},"subtitle":[],"editor":[{"given":"Rachel M A","family":"ter Bekke","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Carlos Minguito","family":"Carazo","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Uffe Jakob Ortved","family":"Gang","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Sara","family":"Monosilio","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":6,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae054","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,2]]},"published":{"date-parts":[[2024,1,31]]},"article-number":"ytae054"}}