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The condition can be separated into two phenotypes: Purkinje-related VF responsive to culprit-tissue ablation and microstructural VF guided by electro-anatomical mapping for substrate-elimination. Ongoing research advances diagnostics and ablation techniques.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/idiopathic-ventricular-fibrillation-substrates-mechanisms-and-treatment-review/459986/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/idiopathic-ventricular-fibrillation-substrates-mechanisms-and-treatment-review/459986.png","ImageObject",300,407,{"name":42,"@type":43},"Marglet","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What does “idiopathic” mean in idiopathic ventricular fibrillation?","Question",{"text":63,"@type":64},"“Idiopathic” refers to a disease that does not arise from any known cause. In idiopathic VF, VF occurs without structural or electrical heart disease and without reversible metabolic or toxic conditions.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why has the proportion of “idiopathic VF” diagnoses changed over time?",{"text":68,"@type":64},"It has progressively decreased due to improved diagnostic workup for patients with resuscitated sudden cardiac death, including better imaging and challenge-based testing.",{"name":70,"@type":61,"acceptedAnswer":71},"How are Purkinje-related and microstructural idiopathic VF differentiated for treatment?",{"text":72,"@type":64},"Purkinje-related VF can show short-coupled ventricular ectopy, making culprit-tissue ablation a reasonable strategy to prevent recurrence. Microstructural idiopathic VF can reveal localized myocardial alterations with thorough electro-anatomical mapping and is amenable to substrate-elimination.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},459986,1790790238,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":107,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},2336477982702,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Idiopathic Ventricular Fibrillation: Substrates, Mechanisms and Treatment  \nMarine Arnaud ,1,2 Josselin Duchateau 1,2 and Mélèze Hocini 1,2  \n1. Department of Cardiac Pacing and Electrophysiology, Hopital Cardiologique du Haut-Leveque, Bordeaux University Hospital (CHU), Bordeaux, France; 2. IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux, France  \nAbstract  \nIdiopathic VF is a complex clinical entity that is characterised by an evolving scope over time. Arrhythmogenic cardiomyopathy and electrical diseases represent a significant proportion of diagnoses attributed during follow-up in patients with an initial diagnosis of idiopathic VF. Stepwise diagnostic workup and management are of paramount importance. We proposed that idiopathic VF can be split into two distinct phenotypes, with potential overlap in an individual patient. In patients with Purkinje-related idiopathic VF, short-coupled ventricular ectopy can be documented, and ablation of the culprit tissue is a reasonable strategy to avoid recurrence. In patients with microstructural idiopathic VF, localised myocardial alterations can be unveiled by thorough electro-anatomical mapping and are amenable to a substrate-elimination strategy. Idiopathic VF is also a dynamic and evolving field, with promising research, new diagnostic tools and ablation techniques being developed in the near future.  \nKeywords  \nIdiopathic ventricular fibrillation, Purkinje, ectopy, microstructural abnormalities  \nReceived: 2 May 2025 Accepted: 9 June 2025 Citation: Arrhythmia & Electrophysiology Review 2025;14:e35 . DOI: [https://doi.org/10.15420/aer.2025.34](https://doi.org/10.15420/aer.2025.34)  \nDisclosure: All authors have no conflicts of interest to declare.  \nCorrespondence: Marine Arnaud, Département de Rythmologie, Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, L’Institut de RYthmologie et modélisation  \nCardiaque (LIRYC), Université Bordeaux, Avenue du Haut Lévêque 33604 Bordeaux-Pessac, France. E: [arnaud.marine@yahoo.fr](arnaud.marine@yahoo.fr)  \nCopyright: © The Author(s) 2025. This work is open access and is licensed under CC BY-NC 4.0. Users may copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.  \nHistorical Background  \nFrom the First Description to Current Views  \nThe term idiopathic comes from Greek roots idios and pathos, meaning a disease that does not arise from any known cause. The first use of‘idiopathic ventricular fibrillation’ was made by Ledwich and Fay in 1969 ina report on a patient in whom cardiac examination, 12-lead ECG and chest X-ray were normal (Figure 1) .1  \nOver time, the proportion of patients labelled as having idiopathic VF has progressively decreased, due to improvements in the diagnostic workup of patients with resuscitated sudden cardiac death. Coronary catheterisation and echocardiography in the late 1960s were the first important diagnostic tests that markedly improved the definition of‘apparently normal heart’. More recently, major progress has been made with cardiac MRI and pharmacological challenges. Arrhythmogenic cardiomyopathy and electrical diseases represent a significant proportion of diagnoses attributed during follow-up in patients with an initial diagnosis of idiopathic VF. In parallel, genetic testing and improved understanding and recognition of cardiac channelopathies (long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia [CPVT], calcium release deficiency syndrome [CRDS]) andarrhythmic syndromes (Brugada, early repolarisation) have further restricted the span of idiopathic VF.2,3  \nTherefore, idiopathic VF is a complex clinical entity that is characterised by an evolving scope over time. The main stem is that it is a diagnosis per exclusion: VF occurring in the absence of structural or electrical heart  \ndisease, or reversible metabolic and toxicological conditions. Since the 1920s","cbCaiprTuAgWTGuN","https://ap.wps.com/l/cbCaiprTuAgWTGuN","pdf",1453166,"English","# Historical Background\n## From the First Description to Current Views\n## Dynamic Reappraisal of “Idiopathic” VF","[{\"question\":\"What does “idiopathic” mean in idiopathic ventricular fibrillation?\",\"answer\":\"“Idiopathic” refers to a disease that does not arise from any known cause. In idiopathic VF, VF occurs without structural or electrical heart disease and without reversible metabolic or toxic conditions.\"},{\"question\":\"Why has the proportion of “idiopathic VF” diagnoses changed over time?\",\"answer\":\"It has progressively decreased due to improved diagnostic workup for patients with resuscitated sudden cardiac death, including better imaging and challenge-based testing.\"},{\"question\":\"How are Purkinje-related and microstructural idiopathic VF differentiated for treatment?\",\"answer\":\"Purkinje-related VF can show short-coupled ventricular ectopy, making culprit-tissue ablation a reasonable strategy to prevent recurrence. Microstructural idiopathic VF can reveal localized myocardial alterations with thorough electro-anatomical mapping and is amenable to substrate-elimination.\"}]","Idiopathic Ventricular Fibrillation - Substrates, Mechanisms and Treatment - Review | PDF",1790757428,18]