Review Article| Volume 15, ISSUE 1, P9-14, March 2023

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Deductive Electrocardiographic Analysis of Left Ventricular Summit Arrhythmias

Published:December 13, 2022DOI:


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        • Enriquez A.
        • Baranchuk A.
        • Briceno D.
        • et al.
        How to use the 12-lead ECG to predict the site of origin of idiopathic ventricular arrhythmias.
        Heart Rhythm. 2019; 16 (Available at:): 1538-1544
        • Enriquez A.
        • Malavassi F.
        • Saenz L.C.
        • et al.
        How to map and ablate left ventricular summit arrhythmias.
        Heart Rhythm. 2017; 14 (Available at:): 141-148
      1. (Am Heart J [Internet]. 1976;92(4):545)Heart and coronary arteries: by wallace A. McAlpine, M.D. Springer-Verlag, New York1975: 223 (Available at:)
        • Kuniewicz M.
        • Baszko A.
        • Ali D.
        • et al.
        Left ventricular summit—concept, anatomical structure and clinical significance.
        Diagnostics. 2021; 11: 1-14
        • Tzeis S.
        • Asvestas D.
        • Yen Ho S.
        • et al.
        Electrocardiographic landmarks of idiopathic ventricular arrhythmia origins.
        Heart. 2019; 105: 1109-1116
        • Komatsu Y.
        • Nogami A.
        • Shinoda Y.
        • et al.
        Idiopathic ventricular arrhythmias originating from the vicinity of the communicating vein of cardiac venous systems at the left ventricular summit.
        Circ Arrhythm Electrophysiol. 2018; 11: 1-10
        • Liao H.
        • Wei W.
        • Tanager K.S.
        • et al.
        Left ventricular summit arrhythmias with an abrupt V3 transition: anatomy of the aortic interleaflet triangle vantage point.
        Heart Rhythm. 2021; 18 (Available at:): 10-19
        • Jauregui Abularach M.E.
        • Campos B.
        • Park K.M.
        • et al.
        Ablation of ventricular arrhythmias arising near the anterior epicardial veins from the left sinus of Valsalva region: ECG features, anatomic distance, and outcome.
        Heart Rhythm [Internet]. 2012; 9 (Available at:): 865-873
        • Yamada T.
        • Kumar V.
        • Yoshida N.
        • et al.
        Eccentric activation patterns in the left ventricular outflow tract during idiopathic ventricular arrhythmias originating from the left ventricular summit: a pitfall for predicting the sites of ventricular arrhythmia origins.
        Circ Arrhythmia Electrophysiol. 2019; 12: 1-12
        • Hayashi T.
        • Santangeli P.
        • Pathak R.K.
        • et al.
        Outcomes of catheter ablation of idiopathic outflow tract ventricular arrhythmias with an R wave pattern break in lead V2: a distinct clinical entity.
        J Cardiovasc Electrophysiol. 2017; 28: 504-514
        • Futyma P.
        • Santangeli P.
        • Pürerfellner H.
        • et al.
        Anatomic approach with bipolar ablation between the left pulmonic cusp and left ventricular outflow tract for left ventricular summit arrhythmias.
        Heart Rhythm. 2020; 17: 1519-1527
        • Santangeli P.
        • Marchlinski F.E.
        • Zado E.S.
        • et al.
        Percutaneous epicardial ablation of ventricular arrhythmias arising from the left ventricular summit.
        Circ Arrhythmia Electrophysiol. 2015; 8: 337-343
        • Yamada T.
        • Doppalapudi H.
        • Maddox W.R.
        • et al.
        Prevalence and electrocardiographic and electrophysiological characteristics of idiopathic ventricular arrhythmias originating from intramural foci in the left ventricular outflow tract.
        Circ Arrhythmia Electrophysiol. 2016; 9: 1-10
        • Chung F.P.
        • Lin C.Y.
        • Shirai Y.
        • et al.
        Outcomes of catheter ablation of ventricular arrhythmia originating from the left ventricular summit: a multicenter study.
        Heart Rhythm. 2020; 17 (Available at:): 1077-1083
        • Berruezo A.
        • Mont L.
        • Nava S.
        • et al.
        Electrocardiographic recognition of the epicardial origin of ventricular tachycardias.
        Circulation. 2004; 109: 1842-1847
        • Vallès E.
        • Bazan V.
        • Marchlinski F.E.
        ECG criteria to identify epicardial ventricular tachycardia in nonischemic cardiomyopathy.
        Circ Arrhythmia Electrophysiol. 2010; 3: 63-71
        • Yamada T.
        • Murakami Y.
        • Yoshida N.
        • et al.
        Preferential conduction across the ventricular outflow septum in ventricular arrhythmias originating from the aortic sinus cusp.
        J Am Coll Cardiol. 2007; 50: 884-891