Key result
Mapping-guided catheter ablation targets diseased Purkinje potentials driving ventricular fibrillation.
Why the study?
Recurrent drug-refractory ventricular fibrillation after myocardial infarction remains challenging to treat, and identifying the target area for ablation is critical.
Case Report (n=1)
Electroanatomical mapping can help identify diseased Purkinje potentials as a target for ablation in recurrent post-MI ventricular fibrillation.
May inform targeted VF ablation in select cases; hypothesis-generating and requires prospective validation before adoption.
A 55-year-old woman experienced recurrent drug-refractory ventricular fibrillation (VF) following recent myocardial infarction despite emergent coronary artery bypass grafting. We performed catheter ablation using the Advisor HD Grid catheter (Abbott) and a 3-dimensional electroanatomical mapping system (EAM, EnSite, Abbott). EAM demonstrated low voltage area (LVA) distribution (Figure 1A). Intracardiac electrogram during VF initiation revealed Purkinje potentials (PP) preceding the QRS complex with shorter coupling intervals, implicating arrhythmogenesis of diseased PP (Figure 1B)1.
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Nakano et al. (2026) conducted a case report in recurrent drug-refractory ventricular fibrillation (VF) (n=1). Catheter ablation using 3D electroanatomical mapping was evaluated. Catheter ablation guided by 3D electroanatomical mapping identified diseased Purkinje potentials as the arrhythmogenic source of ventricular fibrillation.
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