title: Radiofrequency catheter ablation of ventricular arrhythmias in patients with hypertrophic cardiomyopathy: safety and feasibility.
abstract: 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.
authors.affiliation: Texas Cardiac Arrhythmia Institute at St. David Medical Center, University of Texas, Austin, Texas 78705, USA.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santangeli
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Dhanunjay
authors.initials: D
authors.lastname: Lakkireddy
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.forename: Jayasree
authors.initials: J
authors.lastname: Pillarisetti
authors.forename: Yoav
authors.initials: Y
authors.lastname: Michowitz
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sanchez
authors.forename: Rodney
authors.initials: R
authors.lastname: Horton
authors.forename: Prasant
authors.initials: P
authors.lastname: Mohanty
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Gemma
authors.initials: G
authors.lastname: Pelargonio
authors.forename: Pietro
authors.initials: P
authors.lastname: Santarelli
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
authors.forename: Calambur
authors.initials: C
authors.lastname: Narasimhan
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: 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