PO-05-035 FASCICULAR SUBSTRATE MODIFICATION TO TREAT HUMAN VENTRICULAR FIBRILLATION: A MULTICENTER STUDY

Purkinje fibers play an important role in initiation and maintenance of ventricular fibrillation (VF). Fascicular substrate modification approaches have been suggested to treat recurrent VF isolated case reports small series. To investigate the outcomes catheter-based fascicular VF. Out 2,212 consecutive patients with arrhythmia undergoing catheter ablation at our centers, 18 (0.81%) underwent by targeting short (<20 s) RF lesions most distal segment as identified high-density mapping during sinus rhythm. Demographic, clinical, follow-up characteristics were prospectively collected institutional database. A total (mean age: 56±3.8 years, female: 4, 22%) included study. Of those, 11 (61.1%) had idiopathic (normal heart VF), 3 (16.7%) non-ischemic cardiomyopathy 4 (22.2%) mixed cardiomyopathy. Average LVEF was 42.5%. Patients failed ≥2 antiarrhythmic drugs pre-ablation. At baseline, all inducible non-inducibility end procedure achieved 16 (88.9%) patients. In select patients, remapping revealed elimination targeted potentials. procedure, no patient demonstrated new evidence block or bundle branch block. final lesion sets are shown figure 1. There procedure-related complications. After a median 24 months, arrhythmia-free on- off-drugs; 11/11 (100%) normal vs 5/7 (71.4%) underlying (p=0.06). Catheter human is feasible, safe appears highly effective high rates acute long-term freedom from