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\begin{document}

\title{Selective Proximal Left Anterior Fascicle Pacemapping for Guiding narrow
QRS Premature Ventricular Complex ablation from the Right Coronary Cusp}



\author[1]{Diego Penela}%
\author[1]{Alfredo  Chauca}%
\author[1]{David Soto-Iglesias}%
\author[1]{Beatriz Jauregui}%
\author[1]{Augusto Ordoñez}%
\author[1]{Antonio Berruezo}%
\affil[1]{Teknon Medical Center}%


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  \date{May 08, 2024}


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\begin{abstract}
Premature ventricular complexes (PVC) ablation has increased over the
past decades. The morphology of PVCs arising from left anterior fascicle
(LAF) is typically a right bundle branch block-like morphology with an
inferior axis showing a qR or qRs complex in the inferior leads and an
rS or RS complex in leads I and aVL. We describe the case of a 38 years
old woman with symptomatic, high burden PVCs, despite of beta blockers
treatment. The PVC's ECG morphology suggested an origin in the LAF. This
case illustrates how ablation from the right coronary cusp for PVC
arising from the LAF could be accurately guided by pace-mapping. At this
location, pacing at different outputs can result in both a selective and
a non-selective capture of the left anterior fascicle.%
\end{abstract}%



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