Modern mapping and ablation techniques to treat ventricular arrhythmias from the left ventricular summit and interventricular septum

Heart Rhythm. 2020 Sep;17(9):1609-1620. doi: 10.1016/j.hrthm.2020.04.026. Epub 2020 Apr 22.

Abstract

Managing arrhythmias from the left ventricular summit and interventricular septum is a major challenge for the clinical electrophysiologist requiring intimate knowledge of cardiac anatomy, advanced training and expertise. Novel mapping and ablation strategies are needed to treat arrhythmias originating from these regions given the current suboptimal long-term success rates with standard techniques. Herein, we describe innovative approaches to improve acute and long-term clinical outcomes such as mapping and ablation using the septal coronary venous system and the septal coronary arteries, alcohol ablation, coil embolization, and ablation of all early sites among others.

Keywords: Ablation techniques; Interventricular septum; LV summit; Premature ventricular complex; Ventricular tachycardia.

Publication types

  • Review

MeSH terms

  • Catheter Ablation / methods*
  • Electrophysiologic Techniques, Cardiac*
  • Heart Ventricles / physiopathology
  • Humans
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / physiopathology*
  • Tomography, X-Ray Computed
  • Ventricular Septum / diagnostic imaging
  • Ventricular Septum / physiopathology*