The left ventricular summit (LVS) is a triangular area located at the most superior portion of the left epicardial ventricular region, surrounded by the two branches of the left coronary artery: the left anterior interventricular artery and the left circumflex artery. The triangle is bounded by the apex, septal and mitral margins and base. This review aims to provide a systematic and comprehensive anatomical description and proper terminology in the LVS region that may facilitate exchanging information among anatomists and electrophysiologists, increasing knowledge of this cardiac region. We postulate that the most dominant septal perforator (not the first septal perforator) should characterize the LVS definition. Abundant epicardial adipose tissue overlying the LVS myocardium may affect arrhythmogenic processes and electrophysiological procedures within the LVS region. The LVS is divided into two clinically significant regions: accessible and inaccessible areas. Rich arterial and venous coronary vasculature and a relatively dense network of cardiac autonomic nerve fibers are present within the LVS boundaries. Although the approach to the LVS may be challenging, it can be executed indirectly using the surrounding structures. Delivery of the proper radiofrequency energy to the arrhythmia source, avoiding coronary artery damage at the same time, may be a challenge. Therefore, coronary angiography or cardiac computed tomography imaging is strongly recommended before any procedure within the LVS region. Further research on LVS morphology and physiology should increase the safety and effectiveness of invasive electrophysiological procedures performed within this region of the human heart.

The left ventricular summit (LVS) is a triangular area located at the most superior portion of the left epicardial ventricular region, surrounded by the two branches of the left coronary artery: the left anterior interventricular artery and the left circumflex artery. The triangle is bounded by the apex, septal and mitral margins and base. This review aims to provide a systematic and comprehensive anatomical description and proper terminology in the LVS region that may facilitate exchanging information among anatomists and electrophysiologists, increasing knowledge of this cardiac region. We postulate that the most dominant septal perforator (not the first septal perforator) should characterize the LVS definition. Abundant epicardial adipose tissue overlying the LVS myocardium may affect arrhythmogenic processes and electrophysiological procedures within the LVS region. The LVS is divided into two clinically significant regions: accessible and inaccessible areas. Rich arterial and venous coronary vasculature and a relatively dense network of cardiac autonomic nerve fibers are present within the LVS boundaries. Although the approach to the LVS may be challenging, it can be executed indirectly using the surrounding structures. Delivery of the proper radiofrequency energy to the arrhythmia source, avoiding coronary artery damage at the same time, may be a challenge. Therefore, coronary angiography or cardiac computed tomography imaging is strongly recommended before any procedure within the LVS region. Further research on LVS morphology and physiology should increase the safety and effectiveness of invasive electrophysiological procedures performed within this region of the human heart. Published in Diagnostics: https://doi.org/10.3390/diagnostics11081423

In recent times the left ventricular summit (LVS) has become an interesting heart region. This triangular epicardial area is a ventricular arrhythmias source with a high level of difficulty for radiofrequency ablation. Providing systematic and comprehensive anatomical terminology of the LVS region may facilitate the exchanging of information among anatomists and electrophysiologists, increasing knowledge over this heart region. We will provide new anatomical terminology such as the apex of the left ventricular summit, arcuate line, septal margin, and mitral margin, as well as present a recent state of basicscientific knowledge from this heart region.

In recent times the left ventricular summit (LVS) has become an interesting heart region. This triangular epicardial area is a ventricular arrhythmias source with a high level of difficulty for radiofrequency ablation. Providing systematic and comprehensive anatomical terminology of the LVS region may facilitate the exchanging of information among anatomists and electrophysiologists, increasing knowledge over this heart region. We will provide new anatomical terminology such as the apex of the left ventricular summit, arcuate line, septal margin, and mitral margin, as well as present a recent state of basicscientific knowledge from this heart region.

In recent times the left ventricular summit (LVS) has become an interesting heart region. This triangular epicardial area is a ventricular arrhythmias source with a high level of difficulty for radiofrequency ablation. Providing systematic and comprehensive anatomical terminology of the LVS region may facilitate the exchanging of information among anatomists and electrophysiologists, increasing knowledge over this heart region. We will provide new anatomical terminology such as the apex of the left ventricular summit, arcuate line, septal margin, and mitral margin, as well as present a recent state of basicscientific knowledge from this heart region.