Distribution of Successful Ablation Sites of Idiopathic Right Ventricular Outflow Tract Tachycardia

Abstract

This study indicates that the vast majority of successful ablation sites for idiopathic RVOT arrhythmias are located in the transitional-voltage zone. Mapping of the transitional-voltage zone may be an important landmark of RFCA for RVOT arrhythmia.

Relationship between electroanatomical voltage mapping characteristics and breakout site of ventricular activation in idiopathic ventricular tachyarrhythmia originating from the right ventricular outflow tract septum

“…There were 21 patients (75%) including patients whose optimal ablation site was located in the LVA. Recently, Yamashita et al reported similar results: 87.5% of idiopathic RVOT arrhythmias were successfully ablated in the transitional-voltage zone (amplitude between 0.5 and 1.5 mV) and 4.2% in the low-voltage zone (<0.5 mV) [11]. Therefore, the border area including the LVA is the breakout site and/or origin of ventricular arrhythmias.…”

The V2 Transition Ratio

“…The clinical presentation of OTVT is heterogeneous, ranging from isolated premature ventricular contractions (PVCs) to repetitive nonsustained VT to sustained VT. Although this diagnosis can be malignant, it generally carries an excellent prognosis and can be effectively treated by drugs or radiofrequency (RF) catheter ablation (2)(3)(4)(5).…”

Second coupling interval of nonsustained ventricular tachycardia to distinguish malignant from benign outflow tract ventricular tachycardias

“…28 In addition, the successful ablation site for idiopathic RVOT VT is located in the transitional voltage zone, where cellular coupling is presumed to be sparse. 29 Although we did not systematically compare the voltage distribution of the OT regions between the 2 groups, it is highly plausible that VT of the malignant group may be associated with more extensive distribution of the low-voltage zone, resulting in multiple focal discharges or microreentry with different exit sites.…”