Non-fluoroscopic catheter ablation of arrhythmias with origin at the summit of the left ventricle

  • Santiago RiveraEmail author
  • Nicolás Vecchio
  • Paz Ricapito
  • Felix Ayala-Paredes



Catheter ablation of ventricular arrhythmias (VAs) arising from the left ventricular Summit (LVS) is challenging and requires high-dose fluoroscopy to limit vascular damage of the coronary arteries. Ionizing radiation can increase the incidence of malignancies to both patient and operator. This study describes outcomes of catheter ablation of LVS VAs using intracardiac echo-facilitated 3D electroanatomical mapping (ICE-3D) to avoid fluoroscopy.


Twenty-six patients (47 ± 17 years old; 52% males; median ejection fraction 55 ± 13%) with premature ventricular contractions or ventricular tachycardia underwent catheter ablation. VAs were localized using ICE-3D with arrhythmia foci being mapped at the LVS. Focal ablation was performed using a 3.5-mm open-irrigated, contact force sensing radiofrequency catheter.


Acute success and recurrence rates were 84% and 24%, respectively. Holter burden was significantly reduced (24 ± 15% to 1.5 ± 2%; P = 0.01) after ablation. The use of zero fluoroscopy was achieved in 100% of cases. No major complications were observed.


Zero fluoroscopy catheter ablation of LVS VAs using ICE-3D mapping is feasible and effective.


Non-fluoroscopic ablation Intracardiac echocardiography Ventricular arrhythmia 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board.

Informed consent

Each patient gave written informed consent before the procedure.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Cardiovascular Institute of Buenos Aires (ICBA)Buenos AiresArgentina
  2. 2.Centre Hospitalaire Universitaire de Sherbrooke (CHUS)QuebecCanada

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