Electrocardiographic features, mapping and ablation of idiopathic outflow tract ventricular arrhythmias.
Carlo Lavalle, Marco V Mariani, Agostino Piro, Martina Straito, Paolo Severino, Domenico G Della Rocca, Giovanni B Forleo, Jorge Romero, Luigi Di Biase, Francesco Fedele
Author Information
Carlo Lavalle: Department of Cardiovascular Disease, Policlinico Umberto I Hospital, Viale del Policlinico 155, 00161, Rome, Italy. carlo.lavalle@uniroma1.it. ORCID
Marco V Mariani: Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
Agostino Piro: Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
Martina Straito: Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
Paolo Severino: Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
Domenico G Della Rocca: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.
Giovanni B Forleo: Department of Cardiology, Luigi Sacco Hospital, Milan, Italy.
Jorge Romero: Department of Cardiology, Montefiore Medical Center, New York, NY, USA.
Luigi Di Biase: Department of Cardiology, Montefiore Medical Center, New York, NY, USA.
Francesco Fedele: Department of Cardiovascular, Respiratory, Nephrology, Anaesthesiology and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
PURPOSE: Idiopathic outflow tract ventricular arrhythmias are ventricular tachycardias or premature ventricular contractions presumably not related to myocardial scar or disorders of ion channels. These arrhythmias have focal origin and display characteristic electrocardiographic features. The purpose of this article is to review the state of the art of diagnosis and treatment of idiopathic outflow tract ventricular arrhythmias. METHODS: We systematically reviewed scientific literature about idiopathic outflow tract ventricular arrhythmias selecting the most relevant papers on this topic. RESULTS: The right ventricle outflow tract is the most common site of origin for outflow tract ventricular arrhythmias, but also left ventricle outflow tract can harbour these arrhythmias. Outflow tract ventricular arrhythmias are generally benign and may require treatment if they are symptomatic, incessant or give rise to cardiomyopathy. Radiofrequency catheter ablation is an effective and safe therapeutic strategy. A successful procedure requires a thorough preoperative analysis of the 12-lead electrocardiogram of the spontaneous arrhythmia combined with a detailed electroanatomical mapping and intracardiac echocardiography. CONCLUSIONS: Idiopathic outflow tract arrhythmias are frequent in daily clinical practice and can be successfully eliminated through discrete radiofrequency catheter ablation with low rates of complications.
