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Three examples to demonstrate the complex regional anatomy of the outflow tracts: Top Panel. Angiography is being performed through a catheter
engaging the left main coronary artery with a wire advanced into the left anterior descending (LAD) artery. Note the close proximity of catheters advanced
to map outflow tract ventricular ectopy from different cardiac chambers. (E, epicardial space; G, great cardiac vein [GCV]; R, right ventricular outflow tract
[RVOT]). This patient had a high burden of premature ventricular complexes (PVCs) resulting in left ventricular systolic cardiomyopathy. PVCs were
mapped to close proximity of the LAD. After mapping the left ventricular outflow tract (LVOT) and left coronary cusp (LCC) in addition to the
aforementioned sites, radiofrequency ablation was performed in the distal GCV, epicardial region, and the LCC with successful elimination of PVCs
Source: CATHETER-ABLATIVE TECHNIQUES, Hurst's The Heart, 14e
without injury or need for intervention on the LAD. Middle Panel. Anatomic chamber geometry to show the correlative anatomy of the outflow tracts
Citation:
Fuster V, Harrington
Narula
J, Eapenultrasound
ZJ. Hurst'sand
Themapping
Heart, 14e;
2017 Available
at: http://mhmedical.com/
May 05,left,
generated with
three-dimensional
mappingRA,
using
intracardiac
catheters.
AIV, anterior
interventricular vein;Accessed:
LCC/RCC/NCC,
2017
right, and noncoronary cusps (aortic sinuses of Valsalva); LM, left main coronary artery; LV, left ventricle; LVOT, left ventricular outflow tract; PA,
Copyright
© 2017
McGraw-Hill
Education.
rights
reserved
pulmonary artery;
RVOT,
right ventricular
outflow
tract. All
PVC
focus
was mapped and ablated at the commissure between RCC and LCC (maroon spheres).
Bottom Panel. Color-coded three-dimensional activation map of outflow tract ectopy with earliest site at the anterior interventricular vein (AIV)-great