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Electrocardiographic landmarks of idiopathic ventricular arrhythmia origins
  1. Stylianos Tzeis1,
  2. Dimitrios Asvestas1,
  3. Siew Yen Ho2,
  4. Panos Vardas3
  1. 1 Cardiology Department, Mitera General Hospital, Athens, Greece
  2. 2 National Heart and Lung Institute, London, UK
  3. 3 Mitera General Hospital, HYGEIA Group, Athens, Greece
  1. Correspondence to Dr Stylianos Tzeis, Cardiology Department, Mitera General Hospital, Athens 15123, Greece; stzeis{at}


Idiopathic ventricular arrhythmias occur in the absence of underlying structural heart disease and less commonly in the presence of coexistent, but mechanistically unrelated, myocardial scar. These arrhythmias originate from several anatomical sites in both ventricles, with a predilection in outflow tract structures. The 12-lead surface ECG is the initial mapping tool, which is widely used to identify their origin. Specific features can predict the site of idiopathic ventricular arrhythmias, thus differentiating right from left ventricular, as well as endocardial from epicardial origins. In this review, we aim to analyse electrocardiographic landmarks for determination of idiopathic ventricular arrhythmia sources, with specific emphasis on pertinent caveats and anatomical relationships.

  • electrocardiogram
  • idiopathic ventricular tachycardias

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  • Contributors ST and DA have drafted the review, SYH has provided pictures to be included in two figures, while SYH and PV have revised critically the final version to improve its intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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