Management of Idiopathic Outflow Tract Ventricular Arrhythmias

The incidence of idiopathic ventricular arrhythmias (VAs) is increasing, and the outflow tract region is the most common site of origin for these arrhythmias. While these arrhythmias are benign, significant symptoms and cardiomyopathy due to frequent premature ventricular contractions can occur. Ventricular tachycardia and/or premature ventricular contractions can exit from the right ventricular outflow tract, left ventricular outflow tract, or the left ventricular summit. Catheter ablation of outflow tract VAs can be challenging, and a detailed understanding of the complex anatomical relationships in this region and proficiency with advanced techniques, such as bipolar and transcoronary venous ethanol ablation, may be required for successful ablation. This article reviews the management of idiopathic outflow VAs with a focus on catheter ablation.