Life-long tailoring of diagnosis and management of patients with idiopathic ventricular fibrillation—future perspectives in research

Fig. 1. 12-lead electrocardiogram while off anti-arrhythmic drugs, showing normal sinus rhythm, QRS right axis deviation, QRS width 140 ms and prolonged terminal activation duration in V2 (70 ms). Clear J‑point and ST elevation in II, III, and aVF

Fig. 2. 12-lead electrocardiogram while off anti-arrhythmic drugs after 10 years of follow-up, showing negative T waves in V1–V3. Terminal activation delay and J‑point elevation are still present

Fig. 3. Echocardiogram in 2008 showing dilatation of the right ventricle and right ventricular outflow tract. a PLAX RVOT, b PSAX RVOT, c AP4CH-focused RV. PLAX parasternal long axis view, RVOT right ventricular outflow tract, PSAX parasternal short axis view, AP4CH apical 4 chamber view, RV right ventricle

Fig. 4. Flowchart for the diagnosis and follow-up of patients with idiopathic ventricular fibrillation. *In young patients (<45 years) without risk factors for coronary artery disease, coronary computed tomography (CT) angiography is an alternative diagnostic tool to exclude coronary artery disease. ECG electrocardiogram, IVF idiopathic ventricular fibrillation, MRI magnetic resonance imaging, FU follow-up (from Visser et al. [2])