•The MDI measured 0.53 ± 0.10 (median 0.50, IQR 0.47-0.60). •In all (100%) cases MDI was > 0.40 and in 7 (41%) cases it was > 0.55.•Pseudo-delta wave was absent in all but one PVC•PVC origin in the aortic cusps should be considered along with the epicardium when MDI is in the vicinity of 0.55.
MDI
QRS complex maximum deflection index in aortic cusp premature ventricular complexes.
QRS complex maximum deflection index