Idiopathic ventricular fibrillation with repetitive activity inducible within the distal Purkinje system

Michel Haissaguerre, Ghassen Cheniti, William Escande, Alexandre Zhao, Méleze Hocini, Olivier Bernus.

Heart Rhythm, 16 (8). (August 2019): 1268-1272

ABSTRACT
Ventricular ectopy mostly originating from the distal Purkinje system is observed in up to 30% of cases of idiopathic ventricular fibrillation (VF). These ectopies commonly have short coupling R-on-T intervals. However, the Purkinje triggers are often transient, present only during short arrhythmic periods, which prevents recognition of this condition and its treatment. Here, we report 2 patients with idiopathic VF in whom altered electrophysiological properties and inducible repetitive activity were demonstrated in the peripheral Purkinje system in the absence of clinical short-coupled ectopy.