Left Ventricular Summit Arrhythmias: State-of-the-Art Review of Anatomy, Mapping, and Ablation Strategies

Souvik K Das; Joshua Hawson; Youlin Koh; Michael W Lim; Paolo D'Ambrosio; Sohaib A Virk; Danlu Liang; Troy Watts; Jairo Rodriguez Padilla; Kumaraswamy Nanthakumar; Saurabh Kumar; Michael Wong; Paul B Sparks; Ahmed Al-Kaisey; Bhupesh Pathik; Alex McLellan; Joseph B Morton; Peter M Kistler; Jonathan M Kalman; Geoffrey Lee; Robert D Anderson

doi:10.1016/j.jacep.2024.09.008

Left Ventricular Summit Arrhythmias: State-of-the-Art Review of Anatomy, Mapping, and Ablation Strategies

JACC Clin Electrophysiol. 2024 Nov;10(11):2516-2539. doi: 10.1016/j.jacep.2024.09.008. Epub 2024 Oct 30.

Authors

Souvik K Das¹, Joshua Hawson¹, Youlin Koh¹, Michael W Lim¹, Paolo D'Ambrosio², Sohaib A Virk¹, Danlu Liang¹, Troy Watts¹, Jairo Rodriguez Padilla³, Kumaraswamy Nanthakumar⁴, Saurabh Kumar⁵, Michael Wong¹, Paul B Sparks¹, Ahmed Al-Kaisey¹, Bhupesh Pathik¹, Alex McLellan¹, Joseph B Morton¹, Peter M Kistler⁶, Jonathan M Kalman⁷, Geoffrey Lee¹, Robert D Anderson⁸

Affiliations

¹ Department of Cardiology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia.
² Department of Cardiology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia; St. Vincent's Institute of Medical Research, Melbourne, Victoria, Australia.
³ Centre Inria d'Université Côte d'Azur, Sophia Antipolis, France.
⁴ Department of Cardiology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
⁵ Department of Cardiology, Westmead Hospital, Westmead New South Wales, Australia; Westmead Applied Research Centre, University of Sydney, Westmead, New South Wales, Australia.
⁶ Department of Cardiology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia.
⁷ Department of Cardiology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia.
⁸ Department of Cardiology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia. Electronic address: [email protected].

PMID: 39480387
DOI: 10.1016/j.jacep.2024.09.008

Abstract

The left ventricular summit (LVS) is the most common site of epicardial arrhythmias. Ablation of LVS arrhythmias continue to pose a challenge to the electrophysiologist because of its complex and intimate anatomical location. In this review, we undertake a detailed examination of the intricate anatomy of the LVS alongside a comprehensive synthesis of mapping and ablation strategies used to treat LVS arrhythmias.

Keywords: ablation; left ventricular summit; mapping; ventricular arrhythmia; ventricular premature complexes; ventricular tachycardia.

Publication types

Review

MeSH terms

Arrhythmias, Cardiac* / physiopathology
Arrhythmias, Cardiac* / surgery
Catheter Ablation* / methods
Electrophysiologic Techniques, Cardiac
Heart Ventricles* / anatomy & histology
Heart Ventricles* / physiopathology
Humans
Tachycardia, Ventricular / physiopathology
Tachycardia, Ventricular / surgery