Epicardial ablation of premature ventricular beat from right ventricular outflow tract following ineffective endocardial ablation

A case of epicardial ablation of premature ventricular beat (PVB) originating in RVOT outflow tract in an 18-year old patient with frequent symptomatic drug-induced PVB after ineffective endocardial ablation is described. Multiple RF applications by using an irrigated catheter on the side of RVOT turned out ineffective. During epicardial mapping the source of PVB also was in the RVOT area, but with a greater relative and absolute lead. In the course of epicardial ablation, PVB tended to 'heat up', pass into ventricular tachycardia followed by the tatter's arrest and then disappear. At 12-month follow-up the patient showed no ventricular arrhythmias without any antiarrhythmic drugs.