ArticleJACC. Case reports2026
Short-Coupled Purkinje Ventricular Fibrillation Triggers Successfully Suppressed With Flecainide.
Article in JACC. Case reports, 2026. 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundIdiopathic ventricular fibrillation (IVF) affects young individuals without identifiable structural or channelopathic disease. Short-coupled premature ventricular contractions (sc-PVCs) of Purkinje origin are a recognized trigger, yet optimal pharmacotherapy remains undefined. CASE SUMMARY: A 28-year-old healthy woman presented after a witnessed out-of-hospital sudden cardiac arrest. Extensive workup excluded all structural, ischemic, and inherited causes. Telemetry identified sc-PVCs of left anterior fascicle Purkinje origin, with a coupling interval of 330 ms, reproducibly triggering ventricular fibrillation. Intravenous amiodarone and esmolol failed, while flecainide achieved complete sc-PVC suppression. A subcutaneous implantable cardioverter-defibrillator was implanted. DISCUSSION: IVF recurs in 25% to 40% of patients, mandating implantable cardioverter-defibrillator placement and trigger suppression. Quinidine holds an 83.3% efficacy rate but is limited by side effects and availability. Flecainide achieved comparable suppression with sustained benefit at 12-month follow-up on monotherapy. TAKE-HOME MESSAGE: Flecainide is a promising alternative to quinidine for suppressing sc-PVC-triggered IVF, offering comparable efficacy and better tolerability.
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