How to perform Purkinje tissue ablation for the treatment of idiopathic VF.

Idiopathic ventricular fibrillation (IVF) is a complex and heterogeneous clinical entity 1 Viskin S. Belhassen B. Idiopathic ventricular fibrillation. Am Heart J Mosby. 1990; 120: 661-671 Crossref PubMed Scopus (0) Google Scholar . In a significant proportion of patients, short-coupled ventricular ectopy can be documented 2 Haissaguerre M. Vigmond E. Stuyvers B. et al. Ventricular arrhythmias and the His–Purkinje system. Nat Rev Cardiol. 2016; 13: 1-12 Crossref PubMed Scopus (0) Google Scholar , the majority of which originate from the Purkinje system 3 Haïssaguerre M. Shah D.C. Jaïs P. et al. Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation. Lancet. 2002; 359: 677-678 Abstract Full Text Full Text PDF PubMed Scopus (304) Google Scholar . In patients with idiopathic VF due to documented Purkinje ectopy (Purkinje-IVF), ablation of the culprit tissue is a reasonable strategy to avoid arrhythmia recurrence and ICD discharges 4 Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al.: 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J Oxford Academic, 2022; 43:3997–4126. Google Scholar .