Termination of Sustained Ventricular Fibrillation During Radiofrequency Catheter Ablation

After a ST-segment elevation inferior myocardial infarction, a patient developed multiple drug-refractory ventricular fibrillation (VF), triggered by a stereotypic premature ventricular complex. During an episode of sustained VF, catheter ablation of the moderator band terminated VF, with transition into monomorphic ventricular tachycardia. To the best of our knowledge, this is the first-in-human report of termination of VF during delivery of radiofrequency energy, which suggests that the focal area on moderator band of Purkinje system had an active role in the perpetuation of VF. (Level of Difficulty: Advanced.)