Figure 3
Isochronal endocardial activation map generated by the CARTOâ„¢ system. Panel A: Biventricular mapping of his own QRS wave showed that ventricular conduction started at the basal septum, and both left ventricular and right ventricular excitation ended simultaneously within 166ms. Panel B: The local electrograms at the light-blue tag on the right ventricular septum (light-blue circle, â—‹, in Panel A) and at the pink tag on the left ventricular septum (pink circle, â—‹, in Panel A) showed fragmentation. Panel C: Biventricular mapping during right ventricular high-septal pacing showed that ventricular conduction started at the pacing site (white arrow in Panel C), and after the completion of the whole right ventricular excitation, left ventricular conduction started from the septum and ended at the left ventricular lateral wall within 226ms after the pacing. Panel D: The local electrograms at the light-blue tag on the right ventricular septum (light-blue circle, â—‹, in Panel C) and at the pink tag on the left ventricular septum (pink circle, â—‹, in Panel C) showed double potentials that supposedly reflect separated right ventricular and left ventricular excitations. Abbreviations: AoV, aortic valve; LAO, right anterior oblique projection; LV, left ventricular; MA, mitral annulus; RL, right lateral projection; RV, right ventricular; TA, tricuspid annulus.