To be clear we will certainly have central MVHR, but the air volumes that those units produce tend to be only sufficient for keeping the air moving/fresh and not for active cooling.As you passive eg air tight you will need a supply and return in each room it’s normally 2.5-3” duct have a look at zehnder
Main challenge I think is the situations where unexpected heat is generated (aka opening a huge sliding door) and the inbalances that can be locally created. A friend has a new passivhaus and it's super comfortable all year long, except their bedroom in moderately warm summer days.