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New insights on ablation of idiopathic ventricular arrhythmias arising from the right ventricular outflow tract

      Soon after the recognition that radiofrequency energy is a safe and effective energy source for catheter ablation of cardiac arrhythmias, Morady and colleagues
      • Calkins H.
      • Kalbfleisch S.J.
      • El-Atassi R.
      • Langberg J.J.
      • Morady F.
      Relation between efficacy of radiofrequency catheter ablation and site of origin of idiopathic ventricular tachycardia.
      reported 100% efficacy for radiofrequency ablation of idiopathic ventricular tachycardia arising in the right ventricular outflow tract (RVOT).
      • Calkins H.
      • Kalbfleisch S.J.
      • El-Atassi R.
      • Langberg J.J.
      • Morady F.
      Relation between efficacy of radiofrequency catheter ablation and site of origin of idiopathic ventricular tachycardia.
      One of the next major milestones in perfection of catheter ablation of idiopathic ventricular arrhythmias was the identification of the aortic cusps as an important site of origin of idiopathic ventricular arrhythmias with a left bundle branch block inferior axis that could not be ablated from the RVOT.
      • Ouyang F.
      • Fotuhi P.
      • Ho S.Y.
      • et al.
      Repetitive monomorphic ventricular tachycardia originating from the aortic sinus cusp: Electrocardiographic characterization for guiding catheter ablation.
      While the rate of improvements to ablation of idiopathic ventricular arrhythmias has slowed as the efficacy of ablation approaches 100%, creative members of the electrophysiology community continue to provide additional studies that allow further perfection of ablation techniques for idiopathic ventricular arrhythmias.
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      References

        • Calkins H.
        • Kalbfleisch S.J.
        • El-Atassi R.
        • Langberg J.J.
        • Morady F.
        Relation between efficacy of radiofrequency catheter ablation and site of origin of idiopathic ventricular tachycardia.
        Am J Cardiol. 1993; 71: 827-833
        • Ouyang F.
        • Fotuhi P.
        • Ho S.Y.
        • et al.
        Repetitive monomorphic ventricular tachycardia originating from the aortic sinus cusp: Electrocardiographic characterization for guiding catheter ablation.
        J Am Coll Cardiol. 2002; 39: 500-508
        • Dong X.
        • Sun Q.
        • Tang M.
        • Zhang S.
        Catheter ablation of ventricular arrhythmias originating from the junction of pulmonary sinus cusp via a nonreversed U curve approach.
        Heart Rhythm. 2019; 16: 1513-1520

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