Mapping the Left Ventricular Summit for Ablation Success

The majority of outflow tract (OT) arrhythmias originate from the anterior and superior septal aspects of the right ventricular (RV) OT (RVOT) with an underlying mechanism of triggered activity secondary to cyclic adenosine monophosphate–mediated delayed after­ depolarizations.2 However, other origins, including the LV OT (LVOT), coronary cusps (CCs), and distal coronary sinus (CS)—especially when R/S transition occurs at V3 or earlier—have been described.3,4

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