# Electrophysiological characteristics and catheter ablation of ventricular arrhythmias arising from the superior septal left ventricle

## TL;DR

This paper studies the electrical features and ablation treatment of heart rhythm issues coming from a specific left ventricle area.

## Contribution

The study identifies spiky potentials as a key marker for successful ablation in SSLV-originating arrhythmias.

## Key findings

- Spiky potentials (SPs) were found in 32.4% of patients with SSLV-originating PVCs.
- Successful ablation occurred at the earliest SP site in all SP-positive patients.
- PVCs from SSLV showed either narrow or wide QRS morphology with SPs.

## Abstract

Electrophysiological characteristics and radiofrequency catheter ablation (RFCA) of premature ventricular contractions (PVCs) originating from the superior septal left ventricle (SSLV) have not yet been fully characterized.

This study included 247 patients who underwent RFCA for PVCs arising from the ventricular outflow tract between February 2020 and August 2022. The successful ablation site was on the SSLV in 37 of the 247 patients. In 12 (32.4%) of those 37 patients, a low amplitude and high frequency spiky potential (SP) was recognized. Five patients showed a narrow QRS duration (86.8 ± 4.6 ms), with a discrete SP observed in PVCs and sinus rhythm, which showed an isoelectric line with the ventricular electrogram at the earliest activation site. Seven patients showed a wide QRS duration (131.6 ± 4.5 ms), with SP observed in PVCs without an isoelectric line with the ventricular electrogram. RFCA was successful at the site of the earliest SP in all 12 patients. The time from SP onset at the successful ablation site to the QRS onset (local activation time) was 30 ± 12 ms, which differed significantly from that for the remaining 25 patients withoutSP(22.1 ± 7.1 ms, P < 0.05).

SPs were recorded in 12 (32.4%) of the 37 patients with PVCs originating from the SSLV. The morphology of the PVCs may show a narrow or wide QRS duration and the target site for successful ablation should be identified by the earliest SP.

The online version contains supplementary material available at 10.1186/s12872-024-03979-9.