Key result
Purkinje-directed catheter ablation terminates refractory long-duration VF in an ECMO patient.
Why the study?
It remained unknown whether Purkinje system focal triggers play a pivotal role in the initiation and perpetuation of ventricular fibrillation.
Case Report (n=1)
Catheter ablation targeting Purkinje activations may successfully terminate refractory long-duration ventricular fibrillation in patients with ischemic cardiomyopathy.
Answers are grounded in this paper and cite their sources.
May enable rescue ablation in refractory VF on ECMO; hypothesis-generating for Purkinje targeting in ischemic cardiomyopathy.
Catheter ablation is effective for refractory ventricular fibrillation (VF) in ischemic cardiomyopathy.1–6 Focal triggers from the Purkinje system originate at the border zone of the scar, and radiofrequency catheter ablation of those triggers suppresses the recurrence of VF during long-term follow-up.6 However, it remains unknown if these triggers play a pivotal role in the initiation and perpetuation of VF. We present a case of a patient on hemodynamic support, with refractory long-duration VF, which was terminated by catheter ablation to focal Purkinje activities that became self-terminating after the ablation.
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Hasegawa et al. (2020) conducted a case report in Refractory long-duration ventricular fibrillation (n=1). Catheter ablation was evaluated on Termination of ventricular fibrillation. Catheter ablation of focal Purkinje activities successfully terminated refractory long-duration ventricular fibrillation in a patient on ECMO support.
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