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

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: Robert.Anderson4@mh.org.au.

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

Review

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

Souvik K Das et al. JACC Clin Electrophysiol. 2024 Nov.

. 2024 Nov;10(11):2516-2539.

doi: 10.1016/j.jacep.2024.09.008. Epub 2024 Oct 30.

Authors

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: Robert.Anderson4@mh.org.au.

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.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Das is supported by a PhD Scholarship (106804) from the National Heart Foundation of Australia. Dr Kistler is a recipient of an investigatorship from the NHMRC of Australia and has received grants from the Baker Department of Metabolic Health and the University of Melbourne and speaker fees from Abbott Medical. Dr Kalman is supported by an NHMRC practitioner fellowship and has received research support from Biosense Webster and Medtronic. Dr Lee has received consulting fees from Biosense Webster. Dr Anderson has received consulting fees from Biosense Webster. The remaining authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

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LinkOut - more resources

Full Text Sources

Medical