Idiopathic ventricular fibrillation with repetitive activity inducible within the distal Purkinje system
Michel Haissaguerre, Ghassen Cheniti, William Escande, Alexandre Zhao, Méleze Hocini, Olivier Bernus.
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.