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Figure 1 Successful Ablation Site of PVCs Originating From the L-RCC

The first beat is a sinus beat and the second is a premature ventricular contraction (PVC). At the successful ablation site, 2 ventricular activation components and no atrial activations were recorded during sinus rhythm (left panel). The sequence of the 2 components was reversed during the PVCs. The first of the 2 components preceded the QRS onset by 65 ms. The aortagram showed that the ablation catheter was located in the junction of the left and right aortic sinus cusps (L-RCC) (center panels). Note that the tip of the ablation catheter was positioned at the L-RCC by deflecting the loop of the ablation catheter in the left ventricular cavity. The activation map during the PVCs revealed the earliest activation at the L-RCC (right panels). ABLd = distal electrode pair of the ablation catheter; ABLp = proximal electrode pair of the ablation catheter; ABLuni = distal unipolar electrode of the ablation catheter; AP = anteroposterior; LAO = left anterior oblique view; LCC = left coronary cusp; LL = left lateral; LVOT = left ventricular outflow tract; RAO = right anterior oblique view; RCC = right coronary cusp; RVOT = right ventricular outflow tract.