biostudies-literatureUnknown30(39)Kino T<h4>Background</h4>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).<h4>Case summary</h4>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.<h4>Discussion</h4>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.<h4>Take-home message</h4>Deeply recessed Purkinje fibers within LVET can serve as critical triggers for malignant ventricular arrhythmias.JACC. Case reports105982https://www.ebi.ac.uk/biostudies/studies/S-EPMC12859632biostudies-literaturePolymorphic Ventricular Tachycardia From Purkinje Network Within Deep Intertrabecular Recesses in Left Ventricular Excessive Trabeculation.PMC12859632Yumoto KKomatsu YNogami AKino THanaki YfalsePolymorphic Ventricular Tachycardia From Purkinje Network Within Deep Intertrabecular Recesses in Left Ventricular Excessive Trabeculation.<h4>Background</h4>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).<h4>Case summary</h4>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.<h4>Discussion</h4>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.<h4>Take-home message</h4>Deeply recessed Purkinje fibers within LVET can serve as critical triggers for malignant ventricular arrhythmias.2025-01-01T00:00:00Z2025 Dec2026-06-14T03:14:01.074Z2026-06-14T03:08:58.329ZS-EPMC128596324135001610.1016/j.jaccas.2025.105982