Polymorphic Ventricular Tachycardia From Purkinje Network Within Deep Intertrabecular Recesses in Left Ventricular Excessive Trabeculation.

ABSTRACT:

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

SUBMITTER: Kino T 

PROVIDER: S-EPMC12859632 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature