Radiofrequency catheter ablation for treatment of premature ventricular contractions triggering ventricular fibrillation from the right ventricular outflow tract in a patient with early repolarization syndrome

Introduction Ventricular fibrillation (VF) triggered by premature ventricular contraction (PVC) most frequently originates from the His-Purkinje system and right ventricular outflow tract (RVOT) in patients with idiopathic VF. Radiofrequency catheter ablation (RFCA) of triggering PVCs is reportedly useful for the successful elimination of VF. The diagnosis of early repolarization (ER) syndrome is made on the basis of the presence of J-point elevation Z1 mm in Z2 contiguous inferior and/or lateral leads of a standard 12-lead electrocardiogram (ECG) in patients resuscitated from otherwise unexperienced VF or polymorphic ventricular tachycardia (VT). However, the efficacy of RFCA of triggering PVCs in ER syndrome has not been fully evaluated. We report a case in which successful RFCA of triggering PVCs eliminated a VF episode in a patient with ER syndrome.