Background: Catheter ablation has been considered an effective strategy for the treatment of ventricular arrhythmias (VA) originating from the left ventricular summit (LVS). However, the inherent complexity of the anatomy of the LVS may result in failed ablation or recurrence of VA.
Objective: This multicenter study aimed to investigate the procedural outcomes of cathether ablation of LVS VA.
Methods: A total of 238 patients (men, 54.6%; mean age: 53.2 ± 15.0 years) who underwent catheter ablation of LVS VA from four referral centers were included. The demographic characeristics of the patients, procedural parameters, and clinical outcomes were analyzed.
Results: Acute procedural success was achieved in 199 (83.6%) of the patients. Initial epicardial ablation via the coronary venous system (93.8 % [91/97]) or percutaneous transpericardial approach (6.2 % [6/97]) to achieve successful ablation in 40 (41.2%) of 97 patients, and VA was eliminated by initial approaches from aortic sinus of Valsalva or subvalvular endocardium in 68 of 139 patients (48.9%, p = 0.29). Multisite ablations were performed in the process of acute elimination of VA in 105 (51.8%) of patients. During a median follow-up of 26 (1-87) months, 82.2% of patients were free from VA recurrences. The presence of multisite ablation was the only independent predictor of VA recurrences.
Conclusion: Acute elimination of VA originating from the LVS could be achieved in 83.6% of patients with 82.2% without VA recurrences. Despite acute eliminaton of VA in the process of multisite ablation, the incidence of VA recurrence was still high.