Ablation of idiopathic ventricular fibrillation targeting short coupled ventricular premature contractions originating from a right ventricular papillary muscle.

We describe a 38-year-old male who experienced several episodes of syncope after having ventricular fibrillation. The electrocardiographic monitoring after his hospitalization revealed repetitive polymorphic ventricular tachycardias. All polymorphic ventricular tachycardias were consistently initiated by a short-coupled monomorphic ventricular premature contraction (VPC). This VPC was suggested to originate from the inferoposterior region of the right ventricle (RV). Radiofrequency catheter ablation targeting the VPC was successfully performed, and the CARTO merge system (Biosense Webster Inc., Diamond Bar, CA, USA) revealed that the culprit region was the root of the posterior papillary muscle of the RV. A subsequent follow-up of 15 months has been uneventful. < This is a case report of idiopathic ventricular fibrillation (IVF) triggered by a ventricular premature contraction (VPC) from the posterior papillary muscle of the right ventricle. We can learn about the relationship between the anatomical structure and the possible mechanisms of the short-coupled variant of Torsade de Pointes.>.