Mapping and ablation of ventricular arrhythmias arising from the left ventricular summit.
Zhi-Xiang ZhouCheng ZhengYou-Dong HuJia-Feng LinPublished in: Pacing and clinical electrophysiology : PACE (2024)
The left ventricular summit (LVS) refers to the highest portion of the left ventricular outflow tract (LVOT). It is an epicardially delimited triangular area by the left coronary arteries and the coronary venous circulation. Its deep myocardium correlates closely with the left coronary cusp, aortic-mitral continuity, and right ventricular outflow tract (RVOT), complicating the anatomical relationship. Ventricular arrhythmias (VAs) originating from this area are common, accounting for 14.5% of all VAs origin from left ventricle. Specific electrocardiogram (ECG) characteristics may assist in locating LVS-VAs pre-procedure and facilitate procedure planning. However, catheter ablation of LVS-VAs remains challenging because of anatomical constraints. This paper reviews the recent understanding of LVS anatomy, concludes ECG characteristics, and summarizes current mapping and ablation methods for LVS-VAs.
Keyphrases
- left ventricular
- catheter ablation
- aortic stenosis
- left atrial
- mitral valve
- atrial fibrillation
- coronary artery
- coronary artery disease
- hypertrophic cardiomyopathy
- heart failure
- acute myocardial infarction
- cardiac resynchronization therapy
- left atrial appendage
- aortic valve
- pulmonary artery
- transcatheter aortic valve replacement
- high resolution
- minimally invasive
- heart rate
- heart rate variability
- pulmonary hypertension
- high density
- acute coronary syndrome
- systematic review
- blood pressure
- randomized controlled trial
- mass spectrometry
- blood flow