Arrhythmias & electrophysiology
Distinct Purkinje electrogram phenotypes at ventricular fibrillation trigger sites in idiopathic and structural heart disease
- Purkinje-targeted ventricular fibrillation (VF) ablation
- consecutive patients
+1 more
- consecutive patients
Authors' conclusion
Purkinje electrogram morphology at VF-triggering sites differs between idiopathic and structural heart disease and is consistent with differences at the Purkinje-myocardial interface. These findings suggest that electrogram phenotype may inform selection of focal vs substrate-based ablation strategies, supporting a tailored approach that balances arrhythmia control with conduction system preservation.
Study context
- Population
- Patients with idiopathic and structural heart disease undergoing Purkinje-targeted catheter ablation for VF12 patients with discrete trigger localization and high-quality recordings quantitatively analyzed (4 idiopathic, 8 structural) · idiopathic 12 · structural 25
- Participants
- 37 patients
- Comparison
- Purkinje electrogram morphology at VF-triggering sites in patients with idiopathic and structural heart disease
- structural VFn = 8
- idiopathic VFn = 4
Main finding
As reported in the abstract
Further findings
Purkinje potential duration
Purkinje-ventricular intervals
| Outcome | structural VF | idiopathic VF | |
|---|---|---|---|
| Multiphasic components | 3.0 ± 1.1 | 1.0 ± 0.0 | |
| VF-free survival · 12-month | 80.0% | Not reported in the abstract | idiopathic VF: not reported in the abstract |
- Multiphasic components: P < .001
- Purkinje potential duration: P < .001
- Purkinje-ventricular intervals: P < .001
- VF-free survival: P = .79
- VF-free survival: group order as printed: "between groups (83.3% vs 80.0%)"; assignment assumed idiopathic first per earlier order
- VF-free survival: 12-month VF-free survival was similar between groups (83.3% vs 80.0%; P = .79), without specifying which percentage corresponds to idiopathic versus structural VF
Purkinje-to-ventricular intervals in 2 patients with structural VF without voltage-defined scar (septal substrate on computed tomography)
- Purkinje-to-ventricular intervals
- 28 and 35 ms
- values intermediate between those observed in idiopathic VF and voltage scar-positive structural VF
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Summarised from the published abstract; every number is checked against it