Isolated, premature ventricular complex–induced right ventricular dysfunction mimicking arrhythmogenic right ventricular cardiomyopathy Antonio Berruezo,

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Isolated, premature ventricular complex–induced right ventricular dysfunction mimicking arrhythmogenic right ventricular cardiomyopathy Antonio Berruezo, MD, PhD, Elena Efimova, MD, Juan Acosta, MD, Beatriz Jáuregui, MD HeartRhythm Case Reports Volume 4, Issue 6, Pages 222-226 (June 2018) DOI: 10.1016/j.hrcr.2018.02.006 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Electrocardiography recordings. A: At first admission, with premature ventricular contraction (PVC) bigeminy showing left bundle branch block morphology and superior axis. B: At 2-year follow-up, with a new appearance of T-wave inversion in inferior and precordial leads and fragmented QRS in lead III. C: After successful ablation (upright T waves, no PVCs). HeartRhythm Case Reports 2018 4, 222-226DOI: (10.1016/j.hrcr.2018.02.006) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Activation mapping. The earliest activation site appears in the subtricuspidal lateral region. Red dots indicate radiofrequency applications. HeartRhythm Case Reports 2018 4, 222-226DOI: (10.1016/j.hrcr.2018.02.006) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Electroanatomical mapping. Above: Endocardial (Endo) voltage mapping shows discrete unipolar low-voltage areas (red indicates <0.5 mV bipolar and <5.5 mV unipolar) in the subtricuspidal lateral and apical regions. Below: Epicardial (Epi) voltage mapping shows bipolar electroanatomical border zone (amplitude 0.5–1.5 mV on the left and 0.5–1.0 mV on the right) in the lateral wall below the tricuspid annulus. HeartRhythm Case Reports 2018 4, 222-226DOI: (10.1016/j.hrcr.2018.02.006) Copyright © 2018 Heart Rhythm Society Terms and Conditions