Purkinje trigger mapping in postinfarction ventricular fibrillation storm with ventricular abnormal activities detection

Electrical storm, defined as three or more episodes of sustained ventricular arrhythmia within 24 hours, is a life-threatening condition. Post–myocardial infarction (MI) ventricular fibrillation (VF) storms are often triggered by premature ventricular contractions (PVCs) originating from surviving Purkinje fibers within the infarct border zone.1 In the acute or subacute MI phase, ischemic injury to the Purkinje system may cause abnormal automaticity or reentry, whereby a PVC precipitates VF.2,3