Electrocardiographic criteria for differentiating left from right idiopathic outflow tract ventricular arrhythmias

Marco V. Mariani, Agostino Piro, Domenico G. Della Rocca, Giovanni B. Forleo, Naga Venkata Pothineni, Jorge Romero, Luigi Di Biase, Francesco Fedele, Carlo Lavalle

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Idiopathic ventricular arrhythmias are ventricular tachycardias or premature ventricular contractions presumably not related to myocardial scar or disorders of ion channels. Of the ventricular arrhythmias (VAs) without underlying structural heart disease, those arising from the ventricular outflow tracts (OTs) are the most common. The right ventricular outflow tract (RVOT) is the most common site of origin for OT-VAs, but these arrhythmias can, less frequently, originate from the left ventricular outflow tract (LVOT). OT-VAs are focal and have characteristic ECG features based on their anatomical origin. Radiofrequency catheter ablation (RFCA) is an effective and safe treatment strategy for OT-VAs. Prediction of the OT-VA origin according to ECG features is an essential part of the preprocedural planning for RFCA procedures. Several ECG criteria have been proposed for differentiating OT site of origin. Unfortunately, the ECG features of RVOT-VAs and LVOT-VAs are similar and could possibly lead to misdiagnosis. The authors review the ECG criteria used in clinical practice to differentiate RVOT-VAs from LVOT-VAs.

Original languageEnglish (US)
Pages (from-to)10-16
Number of pages7
JournalArrhythmia and Electrophysiology Review
Issue number1
StatePublished - Mar 2021


  • Catheter ablation
  • Electrocardiogram
  • Idiopathic ventricular arrhythmia
  • Ventricular outflow tract

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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