12-lead Holter monitoring is a useful tool for identifying ablation targets in patients with idiopathic ventricular fibrillation when spontaneous arrhythmias are infrequent.
Supports 12-lead Holter for pre-EP target mapping in idiopathic VF; leaves open need for prospective validation.
The management of idiopathic ventricular fibrillation is challenging. While the exact underlying mechanism remains elusive, the Purkinje system appears to be critically involved in many cases. Medical therapy is largely empirical and ablation may be required in patients with drug-refractory arrhythmia. However, targets for ablation may be difficult to identify when the spontaneous arrhythmia occurs infrequently. In this setting, 12-lead Holter monitoring is extremely useful in identifying a potential target for mapping and ablation prior to the electrophysiology study.
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Lipton et al. (2015) studied this question.
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