Idiopathic Outflow Tract Tachycardias

Outflow tract ventricular tachycardias (OT-VTs) re the most common form of idiopathic VTs. In > 80–90% of cases OT-VT originates from the right ventricular outflow tract, however, other origins like the septum, the left ventricular outflow tract, the pulmonary artery, the aortic sinus of Valsalva, the area near the His bundle, and the epicardial surface of the ventricles have been described. OT-VT is a diagnosis by exclusion, i.e., the possible concomitant structural heart disease should be adequately explored and ruled out in all patients presenting with OT-VT. Ablation should be recommended for all patients who present with syncope and who also remain symptomatic despite optimal medical therapy with a well-tolerated drug.