Radiofrequency Ablation and Right Purkinje De-Networking for Moderator Band PVC-Induced VF
Bibliographic record
Abstract
BACKGROUND: Idiopathic ventricular fibrillation (VF) can occasionally be triggered by rare premature ventricular complexes (PVCs), including those from the moderator band. Radiofrequency ablation (RFA) is challenging given low PVC burden and anatomic complexity. CASE SUMMARY: A 36-year-old man with idiopathic VF and an implantable cardioverter-defibrillator for secondary prevention presented with multiple shocks. The VF episodes were triggered by short-coupled PVCs from the moderator band. Despite a low PVC burden (<1%), zero-fluoroscopy catheter ablation was performed. RFA was guided by pace mapping, followed by right-sided Purkinje de-networking. The procedure was uncomplicated, and at 8-month follow-up, the patient remained asymptomatic, with no PVCs or arrhythmic events. DISCUSSION: Low-burden PVC-triggered VF is challenging, as conventional pace mapping is limited. Targeted Purkinje network ablation (de-networking) appears to reduce the risk of recurrent VF. TAKE-HOME-MESSAGE: Pace-mapped RFA combined with ipsilateral Purkinje de-networking may be an effective zero-fluoroscopy strategy for PVC-induced VF, even with low ectopic burden.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".