Curr Treat Options Cardio Med (2015) 17:4 DOI 10.1007/s11936-014-0363-9 Arrhythmia (D Spragg, Section Editor) Ablation of Outflow Tract Ventricular Tachycardia Jackson J. Liang, DO Yuchi Han, MD David S. Frankel, MD * Address * Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Email: david.frankel@uphs.upenn.edu * Springer Science+Business Media New York 2015 This article is part of the Topical Collection on Arrhythmia Keywords Ventricular tachycardia I Outflow tract I Idiopathic I Catheter ablation I Electrocardiogram Opinion statement Ventricular tachycardia in patients with structurally normal hearts is most frequently due to adenosine-sensitive, triggered activity. The most common sites of origin are the right and left ventricular outflow tracts. Patients may present with symptoms such as palpita- tions, or less commonly cardiomyopathy. Treatment options include beta blockers, calcium channel blockers, sodium channel blockers, potassium channel blockers, and catheter ablation. Catheter ablation is highly effective and when performed by a skilled electro- physiologist, can be considered first-line treatment. Knowledge of outflow tract and surrounding anatomy is vital to optimizing results. In this review, we discuss outflow tract anatomy and electrocardiographic morphology, as well as techniques for optimizing ablation outcomes. Introduction Ventricular tachycardia (VT) most often occurs in the setting of structural heart disease, but in 10 % of patients, it occurs in structurally normal hearts and is termed idiopathic [1]. Idiopathic VT most com- monly originates from the right and left ventricular outflow tracts (RVOT and LVOT). The anatomic relationships of the RVOT and LVOT to each other and to their surrounding structures are complex. With a detailed understanding of this anatomy, the 12-lead electrocardiogram (ECG) can be used to lo- calize the arrhythmia site of origin and ablation outcomes can be optimized.