Syncope in a young man: Role of Purkinje fibres in idiopathic ventricular fibrillation

https://doi.org/10.1016/j.ipej.2017.05.006Get rights and content
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Abstract

A young man suffered cardiac arrests with polymorphic ventricular tachycardia (PVT) and ventricular fibrillation (VF) triggered by ventricular premature contractions (PVCs). The arrhythmia was resistant to anti-arrhythmics, so after ICD implantation he underwent successful ablation of the triggering VE beat, which was pace-mapped to the left posterior hemi-fascicle. We review the evidence for the role of the Purkinje network in the initiation and maintenance of PVT and VF, postulating a channelopathy as a possible underlying cause, and provide recommendations for PVC ablation.

Keywords

Ventricular fibrillation
Sudden cardiac death
Purkinje fibres
Channelopathy

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Peer review under responsibility of Indian Heart Rhythm Society.