Polymorphic Ventricular Tachycardia From Purkinje Network Within Deep Intertrabecular Recesses in Left Ventricular Excessive Trabeculation
Tabito Kino1, Akihiko Nogami2, Yuichi Hanaki3
1Department of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan.
Background:
Left ventricular excessive trabeculation (LVET) is associated with malignant ventricular arrhythmias. Polymorphic ventricular tachycardia (PVT) remains particularly challenging, with limited evidence supporting catheter ablation (CA).
Case Summary:
A 53-year-old woman with LVET presented with drug-refractory PVT triggered by short-coupling ventricular premature contractions. Electroanatomical mapping revealed Purkinje and delayed potentials within the left ventricular septum, localized at the base of a recessed trabecular region. CA targeting these signals successfully eliminated inducible PVT. The patient has remained free from recurrent malignant arrhythmias over 11 years of follow-up.
Discussion:
This case highlights the role of the Purkinje fiber network within deep trabeculations in triggering life-threatening arrhythmias. Few reports describe effective CA of PVT in LVET, underscoring the novelty and clinical relevance of this finding.
Take-Home Message:
Deeply recessed Purkinje fibers within LVET can serve as critical triggers for malignant ventricular arrhythmias.
More Related Videos
09:36Dual-Dye Optical Mapping of Hearts from RyR2R2474S Knock-In Mice of Catecholaminergic Polymorphic Ventricular Tachycardia
Published on: December 22, 2023
14:39Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples
Published on: April 21, 2014
Related Concept Videos
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias II: Classification of Tachyarrhythmias
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Mechanism of Cardiac Arrhythmias
Electrophysiology of Normal Cardiac Rhythm
