High-Resolution Mapping and Successful Ablation of Purkinje Ectopy–Triggered Ventricular Fibrillation Storm

Catheter ablation is recognized as a central therapeutic option in treating patients with drug-refractory, scar-related monomorphic ventricular tachycardia (VT). Catheter ablation also has a role in selected cases of polymorphic VT (PMVT) and/or ventricular fibrillation (VF). Rarely, premature ventricular contractions (PVCs) originating from the Purkinje network can induce PMVT/VF. Although not completely elucidated, the electrophysiologic mechanisms behind this lethal arrhythmia have generally been thought to be related to abnormal automaticity and triggered activity. Ablation of the triggering PVCs can prevent VF recurrence and is potentially lifesavin