{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:49:40Z","timestamp":1753890580271,"version":"3.41.2"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Left anterior fascicle (LAF) premature ventricular contractions (PVC) are rarely reported. We described the electrocardiographic and electrophysiological characteristics of PVCs originating from LAF and evaluated the results of catheter ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The baseline AH and HV intervals were recorded during normal sinus rhythm (NSR), and the HV interval of LAF-PVC was measured during the procedure. During the index procedure, the conduction interval from the earliest Purkinje potential (PP) site to the His was labeled as time A, the conduction interval from the earliest site to the onset of the QRS as time B, then the HV interval during NSR (HV<jats:sub><jats:italic>NSR<\/jats:italic><\/jats:sub>) is A + B, and the HV interval during PVC (HV<jats:sub><jats:italic>PVC<\/jats:italic><\/jats:sub>) is B-A; a predicted PP time was calculated using HV<jats:sub><jats:italic>NSR<\/jats:italic><\/jats:sub> and HV<jats:sub><jats:italic>PVC<\/jats:italic><\/jats:sub>. The calculated formula is as follows: Predicted target PP = (HV<jats:sub><jats:italic>NSR<\/jats:italic><\/jats:sub> + HV<jats:sub><jats:italic>PVC<\/jats:italic><\/jats:sub>)\/2. During the repeat procedure, the mapping strategy only focuses on the earliest retrograde PP due to the injury or block of LAF sustained at the index procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Notably, 24 patients with LAF-PVC were included. The ECG characteristics of PVC exhibited right bundle branch block (RBBB) morphology with right-axis deviation (RAD) in 18 patients and only RAD in 6 patients. The QRS durations of NSR and PVC were 78.8 \u00b1 7.9 and 106.8 \u00b1 12.3 ms, respectively. There was no significant difference between the predicted and mapped PP site (31.5 \u00b1 8.1 vs. 30.6 \u00b1 7.8 ms; <jats:italic>P<\/jats:italic> = 0.17). There was a significant difference between the mean axis deviation before and after ablation (46.3 \u00b1 25.4\u00b0 vs. 18.3 \u00b1 44.1\u00b0; <jats:italic>P<\/jats:italic> = 0.001); however, only 10 patients had a complete LAF block. Eight patients had a recurrence, the QRS morphology of LAF-PVC became narrower (95.9 \u00b1 17.2 vs. 105.3 \u00b1 16.9 ms, <jats:italic>P<\/jats:italic> = 0.003), and 4 patients\u2019s PVC QRS morphology was similar to NSR. During the repeat procedure, the earliest retrograde PP interval was longer than the index procedure in four patients (12.0 \u00b1 1.9 vs. 37.8 \u00b1 1.1 ms; <jats:italic>P<\/jats:italic> &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The target PP site for ablation of the LAF region can be calculated using the HV interval during NSR and PVC at the index procedure. The mapping strategy at repeat procedures focused on the earliest retrograde PP interval.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.816237","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T06:22:13Z","timestamp":1648707733000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Premature Ventricular Contractions From the Left Anterior Fascicle: Electrocardiographic and Electrophysiological Characteristics, Mapping Strategy, and Immediate and Long-Term Catheter Ablation Results"],"prefix":"10.3389","volume":"9","author":[{"given":"Hongwu","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangyi","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weizhu","family":"Ju","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengxiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingfang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hailei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zidun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinesh","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kejiang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minglong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1016\/j.hrthm.2015.12.003","article-title":"A novel method to identify the origin of ventricular tachycardia from the left fascicular system.","volume":"13","author":"Chen","year":"2016","journal-title":"Heart Rhythm."},{"key":"B2","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1016\/j.ijcard.2016.07.095","article-title":"Catheter ablation of premature ventricular contractions arising from left anterior fascicle guided by an earliest presystolic Purkinje potential.","volume":"221","author":"Wang","year":"2016","journal-title":"Int J Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e47","DOI":"10.1161\/CIRCEP.113.000249","article-title":"Mapping and ablation of ventricular tachycardia from the left upper fascicle: how to make the most of the fascicular potential?","volume":"6","author":"Ma","year":"2013","journal-title":"Circ Arrhythm Electrophysiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1093\/europace\/euw429","article-title":"Clinical, electrocardiographic, and electrophysiological characteristics of left upper septal fascicular ventricular tachycardia.","volume":"20","author":"Guo","year":"2018","journal-title":"Europace."},{"key":"B5","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1161\/CIRCEP.113.000293","article-title":"Isolated conduction within the left His-Purkenje system during sinus rhythm and idiopathic left ventricle tachycardia: findings from mapping the whole conduction system.","volume":"6","author":"Long","year":"2013","journal-title":"Circ Arrhythm Electrophysiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1046\/j.1460-9592.2001.00088.x","article-title":"Sunao Tawara: a father of modern cardiology.","volume":"24","author":"Suma","year":"2001","journal-title":"Pacing Clin Electrophysiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1161\/01.res.26.3.361","article-title":"Electrophysiological propertiesf the canine peripheral A-V conducting system.","volume":"26","author":"Myerburg","year":"1970","journal-title":"Circ Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1159\/000397645","article-title":"Concept of left hemiblocks revisited. 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