Clinical studies have suggested that there is a significant correlation between left ventricular(LV) false tendon and premature ventricular complexes(PVCs).

This study aimed to investigate the electrophysiological characteristics and the outcome of RFCA for this category of PVCs.

From a total of 2284 patients with idiopathic PVCs who underwent catheter ablation at six institutions in China, ICE was utilized during the procedure in 346 cases, ten patients (2.9%) with PVCs associated with false tendon were retrospectively reviewed and enrolled in the present study. Activation mapping and pace mapping were performed to localize the origin of PVCs. Intracardiac echocardiography (ICE) was used in all patients.If the false tendon was directly visualized and identified, we attempted to identify the distinct relationship with the PVC origin.

The PVCs were successfully eliminated by ablation in all patients.The target sites were confirmed to be related to false tendon . The origin of PVCs was located at the attachment of the false tendon to the papillary muscle, LV septum or LV apex. At the target site, high-frequency Purkinje potentials were observed preceding local ventricular activation in seven patients.

LV false tendon can be associated with PVCs which can be cured by RFCA.. An ICE-guided electroanatomical approach should be considered to improve the safety and feasibility of this procedure.