Ablation of Left Ventricular Posterior Superior Process Premature Beats via Right Atrial Approach

Right Atrial Approach for Ablation of LV Posterior Superior Process Premature Beats

Abstract

In this case report, we present the successful catheter ablation of a 77-year-old patient with symptomatic ventricular premature beats (VPBs) originating from the posterior superior process of the left ventricle. Despite initial challenges in localizing the arrhythmic focus, detailed mapping revealed an ectopic origin within a structurally complex region of the left ventricle. A novel right atrial approach was utilized to access the target site, allowing for precise ablation without requiring transseptal puncture or left ventricular catheterization. The ablation was effective, with complete resolution of VPBs confirmed during follow-up, demonstrating the feasibility and safety of this approach for ectopy originating from difficult-to-reach left ventricular structures.