Radiofrequency catheter ablation of ventricular arrhythmias in patients with hypertrophic cardiomyopathy: safety and feasibility.
BACKGROUND
Management of ventricular tachycardia (VT) in patients with hypertrophic cardiomyopathy (HCM) is challenging.


OBJECTIVE
The purpose of this study is to assess the value of radiofrequency catheter ablation (RFCA) for the treatment of the VTs in the setting of HCM.


METHODS
Twenty-two patients (18 with ICD) with HCM and multiple episodes of VTs resistant to medical therapy underwent RFCA with an open irrigation catheter. Epicardial access was obtained if required. All patients were followed for at least 1 year after RFCA.


RESULTS
Mean age was 50.4 +/- 15.3, and mean ejection fraction was 34.3% +/- 9.8%. RFCA was performed endocardially in all patients, while epicardial radiofrequency applications were needed in 13 patients. A previous endocardial ablation was unsuccessful in six patients. At 20 +/- 9 months of follow-up, elimination of VTs reached 73%. No major complication was observed during and after the procedures in all patients.


CONCLUSIONS
Catheter ablation of VTs in patients with hypertrophic cardiomyopathy refractory to medical therapy is safe, feasible, and successful in eliminating VT. Epicardial VT mapping and ablation should be considered as an important access option for the treatment of these patients to increase the success rate.
Santangeli
Pasquale
P
Texas Cardiac Arrhythmia Institute at St. David Medical Center, University of Texas, Austin, Texas 78705, USA.
Di Biase
Luigi
L
Lakkireddy
Dhanunjay
D
Burkhardt
J David
JD
Pillarisetti
Jayasree
J
Michowitz
Yoav
Y
Sanchez
Javier E
JE
Horton
Rodney
R
Mohanty
Prasant
P
Gallinghouse
G Joseph
GJ
Dello Russo
Antonio
A
Casella
Michela
M
Pelargonio
Gemma
G
Santarelli
Pietro
P
Verma
Atul
A
Narasimhan
Calambur
C
Shivkumar
Kalyanam
K
Natale
Andrea
A
D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome