Cardiac venous system mapping for ventricular arrhythmia localization

The coronary venous system offers a route for mapping and ablation of ventricular arrhythmias with suspected epicardial or intramural origins. Coronary venous mapping helps the operator to select the best ablation approach, decide when percutaneous epicardial access may be necessary and provides an opportunity for therapeutic interventions, including radiofrequency application inside the coronary veins or ethanol infusion. In this article we review the anatomy of the coronary venous system, the scenarios in which coronary venous mapping can be helpful and the technical aspects involved in coronary venous mapping.