Out Flow tract VT,
Diagnostic Tools and
Ablation Weapons
Prof . Dr. Sherif H. Zaky
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LBBB morphology + Inf. AXIS
ANATOMY OF OUTFLOW TRACT
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Clinical Characteristics
How to distinguish malignant
forms of RVOT
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How to distinguish malignant
forms of RVOT
Shimizu W; Heart Rhythm,2009
Arrhythmogenic Right Ventricular
Dysplasia/Cardiomyopathy :
ECG diagnosis
Septal
(Ant.)Free
wall
Betenesky B, JACC,2011, 57; 2255-2263
ECG diagnosis
(LVOT) VT
SUP
INF
RL
These VTs arise from the :
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Right Inf Axis
rS in Lead I
Indications for catheter ablation
Results of catheter ablation
90% success in adult series
5% risk of recurrence
Should ablation not be first line therapy ?
Outcome of Radiofrequency Catheter Ablation in Patients with Idiopathic
Right Ventricular Outflow Tract Tachycardia
Calvo N et al, Indian Pacing and Electrophysiology Journal (13 (1): 14-33 (2013)
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µ
49 Ys old female, Palpitation,
Normal heart and failed 3 AAA
Pacemapping
12/12 lead
matching
Activation
mapping
Clinical VT
30 Ys old male,
Activation
Mapping
LAT = -50 msec
NI, 35 Ys old Female
RVOT
LVOT
Blue dots indicate
Site at which RF
eradicated PVCs
RVOT
LVOT
LEFT CORONARY CUSPOGRAM
LM
CS
RV
LAO
RF
Successful site
Successful site
RF
CS
RV
RAO
START OF RF
Summary
THANK YOU

Out Flow tract VT, Diagnostic Tools and Ablation Weapons