Premature ventricular contractions arising from the pulmonary artery: the use of multielectrode array mapping and cryoablation

Premature ventricular contractions with a left bundle branch block-like morphology and inferior axis typically originate from the right ventricular outflow tract; however, they can also originate from the pulmonary artery. We report two patients with frequent premature ventricular contractions who underwent successful cryoablation of ectopics arising from the posterolateral region of the pulmonary artery. The safe and effective use of cryoablation within the pulmonary artery is discussed. We recommend the use of noncontact mapping with multielectrode array catheter in facilitating the technique and providing a more accurate localization of the ectopic focus within the pulmonary artery, compared with conventional pace mapping methods.