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

Tabito Kino, Akihiko Nogami, Yuichi Hanaki, Yuki Komatsu, Kazuhiko Yumoto

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Tabito KinoDepartment of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan.

Akihiko NogamiDepartment of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan; Department of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan; Department of Cardiology, Tokyo Heart Rhythm Hospital, Tokyo, Japan. Electronic address: akihiko-ind@umin.ac.jp.

Yuichi HanakiDepartment of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan; Department of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.

Yuki KomatsuDepartment of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan; Department of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.

Kazuhiko YumotoDepartment of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft 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.

Indexed as

left ventricular excessive trabeculationnoncompactionpolymorphic ventricular tachycardiaPurkinje networkshort-coupled ventricular premature contractions

Identifiers

PMID41350016

DOI10.1016/j.jaccas.2025.105982

PMCPMC12859632

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