Figure 2. Illustration of the anatomy and the ablation
strategies. (A) The PVVJ was where the PVs adhere to the ventricle
wall. The myocardial extensions were the ventricular musculatures that
extended above the PVVJ. The yellow star indicated the EVA site. (B)
Targeting the EVA site with the antegrade method. (C) The reversed
U-curve was created in the bifurcation of PA by curving, advancing, and
torquing the ablation catheter. Then the reversed U-curve was loosed to
contact the PA wall and retracted into PSC to engage the EVA site.
Abbreviations: EVA=earliest ventricular activating,
PA=pulmonary artery, PSC=pulmonary sinus cusp, PV=pulmonary valve,
PVVJ=pulmonary valve-ventricle junction, RVOT=right ventricular outflow
tract, VA=ventricular arrhythmia.