Key role of intracardiac echocardiography in catheter ablation of anterolateral papillary muscles

Catheter ablation of ventricular arrhythmias originating from papillary muscles (PMs) is challenging due to complex anatomical structures, dynamic motion, and potential deep intramural origin. Intracardiac echocardiography (ICE) has emerged as an essential tool for guiding catheter ablation. We report a case of premature ventricular complexes arising from the anterolateral PM of the left ventricle, successfully ablated under intraprocedural ICE guidance. This case underscores the key role of ICE in overcoming the anatomical challenges of PM ablation and ensuring procedural precision and safety.