Ablation of Focal Intramural Outflow Tract Ventricular Arrhythmias

Jackson J Liang; Frank Bogun

doi:10.1016/j.ccep.2022.04.006

Ablation of Focal Intramural Outflow Tract Ventricular Arrhythmias

Card Electrophysiol Clin. 2023 Mar;15(1):49-56. doi: 10.1016/j.ccep.2022.04.006. Epub 2022 Dec 13.

Authors

Jackson J Liang¹, Frank Bogun²

Affiliations

¹ Electrophysiology Section, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
² Electrophysiology Section, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. Electronic address: fbogun@med.umich.edu.

PMID: 36774136
DOI: 10.1016/j.ccep.2022.04.006

Abstract

Most idiopathic ventricular arrhythmias (VAs) originate from the outflow tract (OT) region and can be targeted with ablation either from the endocardial aspect of the right and left ventricular outflow tracts or from the aortic sinuses of Valsalva. It is important to exclude scar in patients with OT VAs. In some patients, the site of origin may be intramural. Ablation of intramural OT VAs can be challenging to map and ablate due to deep intramural sites of origin. The coronary venous branches may permit mapping and ablation of intramural OT VAs.

Keywords: Ablation; Intramural; PVC; Ventricular arrhythmia; Ventricular tachycardia.

Publication types

Review

MeSH terms

Arrhythmias, Cardiac / surgery
Catheter Ablation* / methods
Electrocardiography
Heart Ventricles / surgery
Humans
Tachycardia, Ventricular* / surgery
Treatment Outcome