Key result
High-resolution mapping and ablation can be lifesaving for Purkinje-triggered polymorphic VT and VF.
Case Report
High-resolution mapping and catheter ablation can be a lifesaving treatment strategy for selected patients with Purkinje ectopy-triggered PMVT and VF storm.
May be considered in refractory Purkinje-triggered VF storm; leaves open need for prospective validation before wider adoption.
Key teaching points•Purkinje ectopy triggering polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) in patients with structural heart disease is a rare entity distinct from short-coupled VF and idiopathic VF.•Purkinje premature ventricular contractions typically have a narrow QRS duration (<120 ms) with rapid downstroke, are short-coupled, and tend to be pleomorphic.•Purkinje ectopy triggering PMVT and VF is generally thought to be caused by abnormal automaticity or triggered activity. Intramyocardial and Purkinje reentry are possible mechanisms that need to be studied in the future.•High-resolution mapping and catheter ablation can be a lifesaving treatment strategy for selected patients with PMVT and VF. •Purkinje ectopy triggering polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF) in patients with structural heart disease is a rare entity distinct from short-coupled VF and idiopathic VF.•Purkinje premature ventricular contractions typically have a narrow QRS duration (<120 ms) with rapid downstroke, are short-coupled, and tend to be pleomorphic.•Purkinje ectopy triggering PMVT and VF is generally thought to be caused by abnormal automaticity or triggered activity. Intramyocardial and Purkinje reentry are possible mechanisms that need to be studied in the future.•High-resolution mapping and catheter ablation can be a lifesaving treatment strategy for selected patients with PMVT and VF.
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Raymond-Paquin et al. (2021) conducted a case report in Purkinje ectopy-triggered polymorphic ventricular tachycardia (PMVT) and ventricular fibrillation (VF). High-resolution mapping and catheter ablation was evaluated. High-resolution mapping and catheter ablation can be a lifesaving treatment strategy for selected patients with Purkinje ectopy-triggered polymorphic ventricular tachycardia and ventricular fibrillation.
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