Arrhythmias & electrophysiologyCohort study
Adjunctive Purkinje Denetworking During Ventricular Tachycardia Ablation in Patients With Prior Ventricular Fibrillation
- Multicenter retrospective cohort study
Authors' conclusion
In this high risk cohort, adjunctive PDN during VT ablation was associated with a substantial reduction in recurrent ventricular arrhythmias, with a modest increase in risk of left bundle branch block. These findings support prospective evaluation of PDN in patients with prior VF.
Study context
- Population
- Patients undergoing monomorphic ventricular tachycardia (VT) ablation (2023–2025) with prior spontaneous polymorphic ventricular tachycardia (PMVT) or ventricular fibrillation (VF)
- Participants
- 27 vs 28
- Exposure
- VT ablation with adjunctive Purkinje de-networking (PDN) vs VT ablation alone
- PDNn = 27
- VT ablation alonen = 28reference
- Outcome
- VT/VF-free survival
- Follow-up
- 12 months
Main finding
As reported in the abstract
Absolute difference
31.6%
By group
Observational data: associations, not effects.
Secondary outcomes
| Outcome | PDN | VT ablation alone | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| VT/VF recurrence | 0.29 (0.11–0.72) | P = 0.017 | |||
| PMVT/VF recurrence | 7.4% | 39.3% | 0.20 (0.07–0.59) | P = 0.018 | |
| 0.050.21520Hazard ratio (log scale) |
Implantable cardioverter-defibrillator therapies
- declined significantly after ablation in both groups
- P < 0.001
Safety
Iatrogenic left bundle branch block
- Iatrogenic left bundle branch block: P = 0.19
Iatrogenic left bundle branch block
- no patients required permanent pacing or device upgrade
Original publication
Adjunctive Purkinje Denetworking During Ventricular Tachycardia Ablation in Patients With Prior Ventricular Fibrillation. JACC Clin Electrophysiol. Published 23 April 2026. doi:10.1016/j.jacep.2026.04.001
Summarised from the published abstract; every number is checked against it