Arrhythmias & electrophysiology
The Empirical Evidence in the Successful Anatomical Ablation of Idiopathic LV Summit Ventricular Arrhythmias: Lessons From Endocardial Mapping
Authors' conclusion
This study suggests that E-RFCA of LVS VAs through an anatomical approach should first target the endocardial EAS rather than sites anatomically closest to the epicardial EAS.
Study context
- Population
- Patients with successful anatomical ablation of idiopathic LV summit ventricular arrhythmias with completed endocardial mappingconsecutive
- Participants
- 40 patients
- Outcome
- Predictors of successful anatomical ablation of left ventricular summit (LVS) ventricular arrhythmias (VAs)
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
- Earliest ventricular activation relative to QRS onset, endocardium (median, range as printed)
- −1 millisecond (−5 to 0 milliseconds)
- Earliest ventricular activation relative to QRS onset, great cardiac vein
- −24 milliseconds (−29 to −18.25 milliseconds)
- Endocardial radiofrequency catheter ablation (E-RFCA) at shortest distance from epicardial earliest activation site (EAS) performed
- 36 patients
- Success of that approach (endocardial earliest activation also at ablation site)
- 20
- Failure of that approach
- 16 patients
- Success at junction of left and right coronary cusps after failure
- 3
- Success at or near endocardial EAS (13 of 16 failed + remaining 4)
- 13 of 16; 4
- Overall success at endocardial EAS
- 37 (93%) of 40 patients
Observational data: associations, not effects.
Original publication
The Empirical Evidence in the Successful Anatomical Ablation of Idiopathic LV Summit Ventricular Arrhythmias: Lessons From Endocardial Mapping. JACC Clin Electrophysiol. Published 30 December 2025. doi:10.
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