{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T04:10:29Z","timestamp":1744344629259,"version":"3.40.4"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Discrete prepotentials (DPPs) mapped inside aortic sinuses of Valsalva (ASVs) are deemed as reliable targets for ablation of premature ventricular contractions (PVCs). Nevertheless, ablation may still fail, necessitating further investigation. This study aimed to investigate the electrophysiological features and ablation approaches for PVCs with failed ablation inside ASVs, despite identified DPPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Patients undergoing PVCs ablation requiring left ventricular outflow tract mapping were consecutively enrolled at six centers. Inclusion criteria comprised the presence of reproducible DPPs in ASVs and the earliest activation inside ASVs preceding the left ventricle. Patients were divided into ASV and non\u2010ASV groups based on ablation outcomes within ASVs. Of 780 assessed patients, 40 (age 47.5\u2009\u00b1\u200919.4; 17 males) were included in the final analysis, with 10 in the non\u2010ASV group. The interval from DPPs to QRS onset (DPP\u2010QRS) in the ASV group significantly exceeded that in the non\u2010ASV group (44.3\u2009\u00b1\u20096.7\u2009ms vs. 15.0\u2009\u00b1\u20095.0\u2009ms, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). A DPP\u2010QRS interval &lt;\u200925\u2009ms perfectly differentiated non\u2010ASV from ASV cases. Successful ablation beneath ASVs was achieved in all non\u2010ASV patients, despite the local potential preceding the QRS onset by only 2.3\u2009\u00b1\u20098.0\u2009ms. In the non\u2010ASV group, the distance between locations of targets and DPPs was 13.3\u2009\u00b1\u20094.2\u2009mm, negatively correlated with the DPP\u2010QRS interval (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.618, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Over a 22\u2010month follow\u2010up, one patient in the non\u2010ASV group had recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DPPs mapped inside ASVs, despite being the earliest sites, do not necessarily represent PVCs targets. An infra\u2010valvular approach is suggested with a DPP\u2010QRS interval &lt;\u200925\u2009ms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16587","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T06:33:56Z","timestamp":1738218836000},"page":"783-793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ablation of Premature Ventricular Contractions With Prepotentials Mapped Inside Coronary Cusps: When to Go Infra\u2010Valvular?"],"prefix":"10.1111","volume":"36","author":[{"given":"Youmei","family":"Shen","sequence":"first","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing 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Cardiology Zhangjiagang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine Zhangjiagang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Cardiology Affiliated Wuxi Hospital of Nanjing University of Chinese Medicine Wuxi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangwei","family":"Ding","sequence":"additional","affiliation":[{"name":"Division of Cardiology Jiangsu Taizhou People's Hospital Taizhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhoushan","family":"Gu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Affiliated Hospital of Nantong University Nantong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Affiliated Hospital of Xuzhou 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