Idiopathic ventricular premature contractions originating from the postero-lateral tricuspid annulus leading to left ventricular disfunction.

A 19-year-old patient with premature ventricular complexes (PVCs) more than 30% on 24 hours was addressed for catheter ablation. Echocardiography showed left ventricular (LV) dilation and systolic dysfunction with 37% of ejection fraction. The patient underwent investigations including cardiac magnetic resonance (MRI) with no other cause of cardiomyopathy being found. Successful ablation of the postero-lateral tricuspid annulus ectopic focus using conventional radiological guiding resulted in normalization of the LV size and contractility. No PVCs were found at follow-up. To our knowledge, this is the first report of PVCs originating in the postero-lateral tricuspid annulus resulting in LV dysfunction.