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: AB: anterobasal; AM: mid anterior; AA anterior apex; SB: basal septum; SM, midseptum; SA, apical septum; PB: basal posterior; PM: mid posterior; PA: posterior apex. Adapted 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 [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