Successful epicardial ablation for ventricular tachycardia originating from the true apex of apical aneurysm associated with hypertrophic cardiomyopathy

Motoki Nakao; Masaya Watanabe; Rui Kamada; Hikaru Hagiwara; Yumi Takahashi; Taro Koya; Takahide Kadosaka; Takuya Koizumi; Masanori Hirose; Toshihisa Anzai

doi:10.1016/j.jelectrocard.2020.06.014

Successful epicardial ablation for ventricular tachycardia originating from the true apex of apical aneurysm associated with hypertrophic cardiomyopathy

J Electrocardiol. 2020 Jul-Aug:61:170-174. doi: 10.1016/j.jelectrocard.2020.06.014. Epub 2020 Jun 16.

Authors

Affiliations

¹ Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan.
² Department of Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan. Electronic address: [email protected].
³ Department of Cardiology, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan.

PMID: 32726710
DOI: 10.1016/j.jelectrocard.2020.06.014

Abstract

Hypertrophic cardiomyopathy (HCM) with apical aneurysm (AA) is rare, but has been reported to be associated with refractory ventricular tachycardias (VTs). Majority of such cases had a central isthmus of the reentry circuit on the border zone of AA. In this report, we describe a rare case of the successful epicardial ablation for a refractory VT originating from a true apex of the aneurysm in a HCM patient. Mid-diastolic potential during sustained VT was recorded at the isolated epicardial myocardium surround by the gross unexcitable scar in AA, and radiofrequency current application rendered VT non-inducible.

Keywords: Ablation; Apical aneurysm; Arrhythmia; Hypertrophic cardiomyopathy; Ventricular tachycardia.

Publication types

Case Reports

MeSH terms

Aneurysm*
Cardiomyopathy, Hypertrophic* / complications
Cardiomyopathy, Hypertrophic* / surgery
Catheter Ablation*
Electrocardiography
Humans
Tachycardia, Ventricular* / surgery