Marshfield Clinic Health System, 1000 North Oak Avenue, Marshfield, WI 54449, USA; University of Maryland School of Medicine, Baltimore, MD, USA.
International Arrhythmia Center, Fundacion CardioInfantil, Bogota, Colombia; Fundacion CardioInfantil, Instituto de Cardiologia, Calle 163 #13b-60, Bogota, Colombia.
Card Electrophysiol Clin. 2023 Mar;15(1):93-109. doi: 10.1016/j.ccep.2022.07.004. Epub 2022 Dec 13.
The left ventricular summit is a site of origin for idiopathic ventricular arrhythmias. With advancements in mapping and ablation techniques, sites previously considered inaccessible can now be approached. Anatomical knowledge of the 3-dimensional landmarks of this space is important, as critical structures reside within its boundaries and are potentially liable to collateral injury during ablation. This article reviews reported complications from ablation of ventricular arrhythmias arising from the left ventricular summit and its vicinity and discusses the pros and cons of different ablation technique and the role of an individualized anatomical approach to reduce procedural related complications and improve outcomes.
左室心尖部是特发性室性心律失常的起源部位。随着标测和消融技术的进步,以前认为无法到达的部位现在也可以进行处理。了解这个空间的三维解剖标志非常重要,因为重要结构位于其边界内,在消融过程中可能会受到间接损伤。本文回顾了左室心尖部及其附近起源的室性心律失常消融的并发症,并讨论了不同消融技术的优缺点以及个体化解剖方法的作用,以降低与手术相关的并发症并改善手术结果。