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Case Report: Successful Ablation of Hisian Ectopy Identified by a Reversed His Bundle Activation Sequence

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Abstract

Junctional ectopy or tachycardia have been mapped and ablated in the atrioventricular node or its posterior extensions. There is no report of Hisian ectopy convincingly demonstrated and then successfully treated by ablation. A 39-year-old man presented with a 9-year history of recurrent supraventricular ectopy refractory to medical treatment. Intracardiac mapping revealed that the ectopy originated from the His bundle, which was indicated by a reversed His bundle activation sequence during ectopy compared to that during sinus rhythm, while the right bundle branch potential was anterogradely activated. Low power RF energy delivered to the site of earliest activation completely abolished the ectopic activity without modification of hisian or atrioventricular conduction. After a 12-month followup, the patient remains free of recurrence.

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Authors and Affiliations

  1. Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France

    Kee-Joon Choi, Dipen C. Shah, Pierre Jais, Meleze Hocini, Teiichi Yamane, Laurent Macle & Michel Haissaguerre

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  1. Kee-Joon Choi
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  2. Dipen C. Shah
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  3. Pierre Jais
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  4. Meleze Hocini
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  5. Teiichi Yamane
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  6. Laurent Macle
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  7. Michel Haissaguerre
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Correspondence to Kee-Joon Choi.

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Choi, KJ., Shah, D.C., Jais, P. et al. Case Report: Successful Ablation of Hisian Ectopy Identified by a Reversed His Bundle Activation Sequence. J Interv Card Electrophysiol 6, 183–186 (2002). https://doi.org/10.1023/A:1015375803028

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  • DOI: https://doi.org/10.1023/A:1015375803028

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