Marked Long-Term PVC Reduction During PCI for LCx CTO From the LV Summit Origin

BACKGROUND: Premature ventricular contractions (PVCs) are often observed as a complication during percutaneous coronary intervention (PCI); however, it is rare for PVCs to decrease over the long-term due to procedural complications. Treating ventricular arrhythmias that originate from the left ventricular (LV) summit using catheter ablation is difficult. CASE SUMMARY: The patient experienced frequent PVCs originating from the LV summit. During PCI for a chronic total occlusion of the left circumflex artery, the PVCs reduced markedly and remained suppressed for 3 years. DISCUSSION: PVC suppression may have been caused by mechanical compression applied to the myocardium near the LV summit due to stent placement near the left main trunk (LMT) and the resulting compression from the hematoma and plaque. This rare case suggests that PCI near the LMT can interfere with arrhythmias that originate from the LV summit. TAKE-HOME MESSAGE: Arrhythmias originating from the LV summit may be suppressed during PCI for the left circumflex artery near the LMT.