Challenges in ablating ventricular arrhythmias originating from the left ventricular summit region.

IF 0.7 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology in the Young Pub Date : 2025-10-03 DOI:10.1017/S1047951125109864

Musa Öztürk, İlker Ertuğrul, Tevfik Karagöz

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引用次数: 0

Abstract

Background: Radiofrequency catheter ablation of ventricular arrhythmias, originating from the left ventricular summit, is challenging due to epicardial localisation of the substrate, surrounded by coronary arteries. This paper highlights the successful elimination of LVOT summit ventricular arrhythmia which was ablated from the aortic cusp and aortic mitral continuity in two paediatric patients.

Case report: Ventricular tachycardia arising from the basal region of the left ventricular summit was identified in two male patients aged 9 and 13 years. Electroanatomic mapping of ventricular arrhythmia revealed the earliest ventricular signal within the left coronary artery which was successfully ablated from the left coronary cusp. The second patient with exactly similar ECG of ventricular arrhythmia was treated by delivering energy to the aorta-mitral continuity beneath the aortic valve. No recurrences were observed during the follow-up period of 20 months.

Conclusion: Ventricular tachycardia arising from the basal region of the left ventricular summit is very rarely observed in paediatric patients. Utilising radiofrequency catheter ablation in proximity to the source can effectively and safely eliminate tachycardia.

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消融源自左心室顶区的室性心律失常的挑战。

背景：射频导管消融室性心律失常，起源于左心室顶点，是具有挑战性的，因为底物的心外膜定位，被冠状动脉包围。本文重点报道了两例小儿患者从主动脉尖和主动脉二尖瓣连续性切除LVOT顶点室性心律失常的成功消除。病例报告：室性心动过速起源于左心室峰顶基底区，在两名年龄分别为9岁和13岁的男性患者中被确诊。室性心律失常的电解剖图显示了左冠状动脉内最早的心室信号，并从左冠状动脉尖成功消融。第二例心电图完全相似的室性心律失常患者通过向主动脉瓣下的主动脉-二尖瓣连续性输送能量来治疗。随访20个月，无复发。结论：室性心动过速发生在左心室顶点基底区是非常罕见的患儿。利用射频导管消融接近源可以有效和安全地消除心动过速。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology in the Young 医学-小儿科

CiteScore

1.70

自引率

10.00%

发文量

715

审稿时长

4-8 weeks

期刊介绍： Cardiology in the Young is devoted to cardiovascular issues affecting the young, and the older patient suffering the sequels of congenital heart disease, or other cardiac diseases acquired in childhood. The journal serves the interests of all professionals concerned with these topics. By design, the journal is international and multidisciplinary in its approach, and members of the editorial board take an active role in the its mission, helping to make it the essential journal in paediatric cardiology. All aspects of paediatric cardiology are covered within the journal. The content includes original articles, brief reports, editorials, reviews, and papers devoted to continuing professional development.