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Clinical and electrophysiological characteristics in patients with sustained monomorphic reentrant ventricular tachycardia associated with dilated-phase hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  22048994     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AimsLittle is known about sustained monomorphic ventricular tachycardia (SMVT) associated with dilated-phase hypertrophic cardiomyopathy (DHCM). The purpose of this study was to clarify the clinical characteristics and effectiveness of catheter ablation for SMVTs in DHCM patients.Methods and resultsFive patients with DHCM (mean age; 67.0 years old, five males) who underwent catheter ablation for drug-refractory SMVTs were included the study. Four of five patients suffered from electrical storm. When the endocardial ablation failed, epicardial and/or intracoronary ethanol ablation, or surgical cryoablation was performed. We reviewed all ablation procedures and electrocardiogram (ECG) of targeted SMVTs. A total of 13 SMVTs were targeted for ablation. Mechanism of all ventricular tachycardias (VTs) was diagnosed as reentry. Endocardial ablation successfully eliminated all VTs in two patients. The remaining three patients needed epicardial ablation, intracoronary ethanol ablation, and surgical cryoablation. All but one VT arose from the basal septum, basal anterior to anterolateral left ventricle (LV). Although the ECGs demonstrated similar features of idiopathic outflow or mitral annulus VTs reflecting the origins, there were characteristic multiple QRS deflections. Following the ablation, four (80%) of the five patients are free from VT recurrence during 18 months of the follow-up period.ConclusionsIn DHCM patients, VT circuits predominantly distributed in the basal septum and the basal anterior to anterolateral LV. In addition to the endocardial ablation, alternative approaches were required in some patients.
Authors:
Akiko Ueda; Seiji Fukamizu; Kyoko Soejima; Tamotsu Tejima; Mitsuhiro Nishizaki; Takashi Nitta; Youichi Kobayashi; Masayasu Hiraoka; Harumizu Sakurada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-1
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan.
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