Catheter Ablation of Premature Ventricular Contractions Arising from the Mitral Annulus after Mitral Valvoplasty

A 57‐year‐old man undergoing mitral valvoplasty underwent catheter ablation of symptomatic premature ventricular contractions (PVCs) with a right bundle branch block and right inferior axis QRS morphology. Left ventriculography revealed a normal left ventricular function and visualized the anatomical relationships between the left ventricular outflow tract and the mitral annuloplasty ring. Electroanatomic mapping during the PVCs revealed a centrifugal activation pattern arising from the mitral annulus, and the PVCs were likely to be idiopathic. Successful radiofrequency ablation was achieved at the site close to the antero‐paraseptal end of the mitral annuloplasty ring, which was located adjacent to the fibrous trigone.