Idiopathic left ventricular outflow tract ectopy: A single focus with extremely divergent breakouts

Background: Idiopathic ventricular tachycardia (VT) and/or premature ventricular contractions (PVCs) arise most commonly from the right ventricular outflow tract and less frequently from the left ventricular outflow tract (LVOT), either below or above the semilunar valves. Case presentation: We report a case of 24-year-old man with idiopathic ventricular tachycardia from a single focus in the supravalvular left ventricular outflow tract with two extremely divergent breakouts observed during the ablation procedure. Conclusion: Focal sources of ventricular arrhythmia in the aortic root may have different preferential exits and meticulous activation sequence mapping is the preferable strategy to delineate the site of origin.