{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:42:44Z","timestamp":1789486964989,"version":"build-2803163510"},"reference-count":60,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ventricular fibrillation (VF) is the primary arrhythmia causing sudden cardiac death. While typically linked to structural heart disease, a significant subset of VF episodes\u2014especially in younger individuals\u2014is triggered by focal ectopy from the His\u2010Purkinje system (HPS). The HPS possesses distinct electrophysiological properties that make it inherently susceptible to arrhythmogenesis. It serves a dual role, acting as both a primary source of initiating premature ventricular complexes through abnormal automaticity and triggered activity (early and delayed afterdepolarizations), and as a critical substrate maintaining VF via micro\u2010re\u2010entrant circuits. This narrative review comprehensively synthesizes current knowledge on Purkinje\u2010triggered VF, from its epidemiology and clinical setting to its underlying pathophysiological and ionic mechanisms of arrhythmia initiation and perpetuation. Finally, we critically evaluate contemporary diagnostic and management strategies, contrasting conventional focal trigger\u2010based ablation with evolving substrate\u2010based approaches such as Purkinje \u201cde\u2010networking.\u201d<\/jats:p>","DOI":"10.1111\/jce.70457","type":"journal-article","created":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T11:51:22Z","timestamp":1784461882000},"page":"2083-2096","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Idiopathic Ventricular Fibrillation Triggered by Purkinje\u2010Related Extrasystoles: State\u2010of\u2010the\u2010Art and Novel Therapeutic Approaches"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-9418","authenticated-orcid":false,"given":"Giacomo","family":"Mugnai","sequence":"first","affiliation":[{"name":"Division of Cardiology, Cardio\u2010Thoracic Department University Hospital of Verona Verona 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