Catheter Ablation of Idiopathic Left Ventricular Outflow Tract Tachycardia Originating from the Left Sinus of Valsalva Experience of 11 Cases

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It has been reported that ventricular outflow tract tachycardia (OT-VT) can be successfully ablated from the left sinus of valsalva (LSV) in some portion of cases, up to about 10% of all idiopathic outflow tract tachycardia. We performed radiofrequency catheter ablation for OT-VT which was thought to be originating from LSV to 11 patients. 10 out of 11 cases were successfully ablated from the LSV. Among 10 cases, 8 had isolated pre-systolic potentials preceding the QRS complex of PVC (P1 potential) at the anterior part of LSV and 9 cases had potentials following the QRS complex (P2 potential) during sinus rhythm. 8 in 9 cases P2 potentials disappeared or delayed after successful RFCA. Successful 10 cases had no recurrence for a follow-up period of 18±15 months. Pace mapping could be performed at the RF deliver site only in 7 cases in which the captured QRS morphology completely matched the target PVC only in 4 cases. These observation suggested that RFCA at site with P1 and P2 potentials were associated with procedual and long-term clinical success in OT-VT targeted from the LSV.