Author + information
- Received August 7, 2017
- Revision received December 1, 2017
- Accepted December 28, 2017
- Published online March 19, 2018.
- Miyako Igarashi, MDa,
- Akihiko Nogami, MDa,∗ (, )
- Kenji Kurosaki, MDb,
- Yuichi Hanaki, MDa,
- Yuki Komatsu, MDa,
- Seiji Fukamizu, MDc,
- Itsuro Morishima, MDd,
- Kazuaki Kaitani, MDe,
- Suguru Nishiuchi, MDe,
- Ahmed Karim Talib, MDa,
- Takeshi Machino, MDa,
- Kenji Kuroki, MDa,
- Hiro Yamasaki, MDa,
- Nobuyuki Murakoshi, MDa,
- Yukio Sekiguchi, MDa,
- Keisuke Kuga, MDa and
- Kazutaka Aonuma, MDa
- aDepartment of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- bDepartment of Heart Rhythm Management, Yokohama Rosai Hospital, Yokohama, Japan
- cDepartment of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
- dDepartment of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
- eDepartment of Cardiology, Tenri Hospital, Tenri, Japan
- ↵∗Address for correspondence:
Dr. Akihiko Nogami, Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
Objectives This study evaluated the characteristics and results of radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in patients with hypertrophic cardiomyopathy (HCM) and left ventricular apical aneurysm (AA).
Background Monomorphic VT in patients with HCM and left ventricular AA has been reported. However, outcome data of RFCA are insufficient.
Methods Fifteen patients with HCM and AA who underwent RFCA for VT at 5 different institutions were included in this study. The data were evaluated retrospectively.
Results Endocardial voltage mapping showed a low-voltage area (LVA), and late potential in the AA was recorded in 12 patients (80%). Although epicardial or intramural origin of VT was suspected in 7 patients, endocardial RFCA successfully suppressed the VT at the LVA border (n = 10) or within the LVA (n = 2). In 2 of 3 patients without LVA at the endocardial site, linear RFCA at the anterior wall of the aneurysmal neck side was successful. In the remaining patient, endocardial RFCA of AA was not effective, and epicardial RFCA site was needed. In all patients, clinical VT became noninducible after RFCA. VT recurrence was observed in 2 patients (13.3%) during the 12-month follow-up period. One patient underwent a second endocardial RFCA, and no VT recurrence was noted. In the other patient, VT recurred 3 months after RFCA and was successfully terminated by antitachycardia pacing of the implantable cardioverter-defibrillator.
Conclusions In patients with HCM and AA, endocardial RFCA of AA effectively suppressed monomorphic VT which was related to AA and resulted in satisfactory outcomes.
- apical aneurysm
- hypertrophic cardiomyopathy
- outcome radiofrequency catheter ablation
- ventricular tachycardia
Dr. Nogami has received research grants from Medtronic; and honoraria from Daiichi Sankyo, St. Jude Medical, and Japan Life Line. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors' institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received August 7, 2017.
- Revision received December 1, 2017.
- Accepted December 28, 2017.
- 2018 American College of Cardiology Foundation
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