Localisation of the origin of a ventricular tachycardia

Areas of the left ventricle where VT's can originate from: The left ventricle is depicted as having been opened. Regionsare as follows: IAS: inferoapical septum; AAS: anteroapical septum; AA anteroapical free wall; AB: antero-basal free wall; ABS, anterobasal and midseptum; IBS, inferobasal septum; IM: infero-medial freewall; IL: infero lateral free wall; MI: midinferiorwall; IA: infero apical free wall.Adopted from Miller et al.[1]

The localisation of the origin (or exit site) of a ventricular tachycardia can be helpful in understanding the cause of the VT and is very helpful when planning an ablation procedure to treat a ventricular tachycardia.

Using this approach and the algorithm on the right (to be added soon) [2] the exit site can be estimated with reasonable accuracy (PPV around 70%).

Localising the VT exit in LBBB VT with negative QRS complexes inferior

Localising the VT exit in LBBB VT with positive QRS complexes inferior

Localising the VT exit in RBBB VT with positive QRS complexes inferior

Localising the VT exit in RBBB VT with negative QRS complexes inferior