Mapping and radiofrequency catheter ablation demonstrated that rare idiopathic LVOT VTs with an inferior axis and monophasic R waves originate from the aortomitral continuity.
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May inform ablation site selection in rare idiopathic LVOT VT; leaves open validation in larger cohorts.
Idiopathic ventricular tachycardia (VT) originating from the left ventricular outflow tract (LVOT) is rare. We report two patients whose QRS configuration during VT commonly showed an inferior axis and monophasic R waves in all the precordial leads. The mechanism of these VTs appeared to be triggered activity. From mapping and ablation, the origin of these VTs was determined to be in the most posterior LVOT, corresponding to the aortomitral continuity (left fibrous trigone).
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Shimoike et al. (1998) studied this question.
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