Arrhythmias & electrophysiology
Ablation of idiopathic ventricular arrhythmias from the right ventricular apex
Authors' conclusion
RV apical VAs demonstrate a distinctive ECG morphology that aids localization. Catheter ablation is effective but may require an epicardial approach.
Study context
- Population
- Patients undergoing catheter ablation for idiopathic right ventricle (RV) apical ventricular arrhythmias (premature ventricular contractions (PVCs) or VT), excluding moderator band, papillary muscle or significant structural heart disease
- Participants
- 12 patients
- Outcome
- Electrocardiographic (ECG) characteristics and ablation outcomes of RV apical VAs
Methodological details3 centres
- 3 centres
Main finding
As reported in the abstract
- Mean QRS duration (ms)
- 167 ± 14
- Single ablation procedure
- 9 (75%)
- 1 repeat procedure
- 2 (17%)
- 2 repeat procedures
- 1 (8%)
- Endocardial ablation effective
- 8 (67%)
- Endocardial and epicardial ablation required
- 4 (33%)
- Free of recurrence (7 by rhythm monitoring, 3 by symptom resolution), of 11 followed
- 10 (91%)
- Antiarrhythmic therapy for recurrence
- 1 (9%)
Observational data: associations, not effects.
Further findings
Arrhythmia type
- PVCs
- 4 (33%)
- Monomorphic VT
- 7 (58%)
- PVCs triggering VF
- 1 (8%)
Suspected PVC-induced cardiomyopathy
- Patients
- 2
- Fully recovered
- 1
- Progressed to HF requiring transplantation despite normal CMR and PVC suppression
- 1
ICD extracted after successful ablation
- ICD extracted
- 1
Original publication
Ablation of idiopathic ventricular arrhythmias from the right ventricular apex. Heart Rhythm. Published 20 November 2025. doi:10.
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