A case of ventricular premature contractions with multiple morphologies
reproduced by a single ventricular extrastimulus with different coupling
intervals
Abstract
; Introduction: A 22-year-old male with no prior cardiovascular
history presented with frequent symptomatic ventricular premature
contractions (VPCs) with multiple QRS morphologies despite bisoprolol
treatment. Results: The coupling intervals progressively increased from
VPC1 to VPC3, and VPC2 was the most frequent (VPC1: 9.3%, VPC2: 30.2%,
VPC3: 0.5%). The earliest activation site was identified at the
left-right coronary cusp junction. Single ventricular extrastimuli with
variable coupling intervals from this site successfully reproduced QRS
morphologies identical to VPC 1-3. Conclusion: The findings revealed the
utility of unique pace-mapping technique in cases of VPCs with multiple
morphologies.