Author + information
- Received October 22, 2018
- Revision received November 13, 2018
- Accepted November 21, 2018
- Published online January 21, 2019.
- Jim W. Cheung, MDa,∗ (, )
- Robert H. Anderson, MD, PhDb,
- Steven M. Markowitz, MDa and
- Bruce B. Lerman, MDa
- aDepartment of Medicine, Division of Cardiology, Weill Cornell Medicine—New York Presbyterian Hospital, New York, New York
- bInstitute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
- ↵∗Address for correspondence:
Dr. Jim W. Cheung, Division of Cardiology, Weill Cornell Medicine, 520 East 70th Street, 4th Floor, New York, New York 10065.
The left ventricular outflow tract (LVOT) is a frequent source of arrhythmias in patients with and without structural heart disease. An understanding of the anatomic relationship between the aortic valvar leaflets and their supporting sinuses, coronary vessels, pulmonary arterial root, right ventricular outflow tract, and LVOT is essential for successful treatment of arrhythmias arising from this region. The juxtaposition of aortic valvar leaflet insertion into the aortic root and the crescents of myocardial tissue incorporated within the aortic sinuses of Valsalva has implications for mapping and ablation above and below the aortic valve leaflets. The presence of epicardial fat, coronary arteries, and prominent myocardium in the anteroseptal aspect of the LVOT can present unique challenges for targeting LV summit and intramural ventricular arrhythmias. Advances in ablation techniques that achieve deeper transmural lesions, combined with the knowledge of the complex LVOT anatomy and its adjoining structures, have increased success rates in targeting challenging LVOT arrhythmias.
- aortic root
- aortic sinuses of Valsalva
- catheter ablation
- left ventricular outflow tract
- left ventricular summit
Dr. Cheung has received consulting fees from Biosense Webster; and has received fellowship grant support from Abbott Medical, Biosense Webster, and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received October 22, 2018.
- Revision received November 13, 2018.
- Accepted November 21, 2018.
- 2019 American College of Cardiology Foundation
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