Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Studies on catheter ablation of hypertrophic cardiomyopathy (HCM)- ventricular tachycardia (VT) are relatively limited and mainly focused on feasibility and safety, whereas the VT distribution and electrophysiological properties remain insufficiently characterized.
Objectives: The aim of this study was to detail the site-specific electrophysiological properties and ablation outcomes in HCM-VT.
Methods: A total of 32 patients with HCM-VT who underwent catheter ablation were included. Through endocardial and epicardial mapping, their arrhythmogenic substrate and re-entrant circuit were identified and analyzed.
Results: Combined endocardial/epicardial mapping was performed in 29 of the 32 patients. Twenty-eight VTs were induced among 25 patients, including 25 scar-mediated re-entries, 2 focal origins, and one bundle branch re-entry. Twenty-five re-entries were localized to the left ventricular (LV) lateral wall (9 of 25), apical aneurysm (6 of 25), superior basal regions (8 of 25), interventricular septum (1 of 25), and papillary muscle (1 of 25), respectively. Incomplete activation sequences were recorded across regions: LV lateral wall (epicardium: 54.3% ± 11.7%; endocardium: 35.9% ± 15.5%), apical aneurysm (endocardium: 40.3% ± 25.0%; epicardium: 32.7% ± 22.6%), and superior basal regions (endocardium: 25.5% ± 7.7%; epicardium: 27.2% ± 11.4%). Over a median follow-up of 31 months, the long-term VT-free survival rate after the index procedure was 73.3% in the LV lateral wall, 83.3% in the apical aneurysm, and 0% in the LV superior basal region and septum, which was consistent with the extent of mid-myocardial involvement. The VT-free survival rate after multiple procedures was 71.9% in all patients.
Conclusions: HCM-VTs were primarily three-dimensional re-entrant circuits with mid-myocardial involvement. Procedural success largely depended on the origin and extent of intramural involvement of VT re-entry.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jacep.2025.05.028 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Breaking the Circuit: A Case of Macro-re-entrant Biatrial Tachycardia.
J Innov Card Rhythm Manag
August 2025
Cardiology Division, Hamilton Health Sciences, Arrhythmia Service Unit, McMaster University, Hamilton, ON, Canada.
We present a case of a 71-year-old woman with symptomatic paroxysmal atrial fibrillation and atypical atrial flutter (AFL), ultimately diagnosed with a rare type 3 macro-re-entrant biatrial tachycardia (BiAT). Despite initial pulmonary vein isolation and anterior line ablation for atypical AFL, she experienced recurrent AFL requiring a complex redo ablation. Successful termination of the tachycardia was achieved by extending ablation to the septal regions of both atria.
View Article and Find Full Text PDFCase Report: From multimodality imaging to catheter ablation of ventricular arrhythmias in arrhythmogenic mitral valve prolapse.
Front Physiol
August 2025
Department of Electrophysiology, King Abdulaziz Cardiac Center, King Abdullah International Medical Research Center (KAIMRC), MNGHA, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Background: Mitral valve prolapse (MVP) is a common condition, typically benign, but in a small subset of patients, it may lead to life-threatening arrhythmias and sudden cardiac death (SCD). This arrhythmogenic MVP phenotype is often associated with bileaflet prolapse, mitral annular disjunction (MAD), and myocardial fibrosis identified via late gadolinium enhancement (LGE) on cardiac MRI.
Case Summary: Our patient is a 49-year-old man presented with monomorphic ventricular tachycardia and near-syncope.
Feasibility study of intravascular pulsed electric field ablation for the treatment of cardiac arrhythmias.
Front Physiol
August 2025
Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China.
Background: Pulsed electric field ablation (PFA) techniques for treating cardiac arrhythmias have attracted considerable interest. For example, atrial fibrillation can be effectively treated by pulmonary vein isolation using PFA. However, some arrhythmias originate deep within the myocardium, making them difficult to reach with conventional ablation methods.
View Article and Find Full Text PDFOutcomes in patients with cardiac amyloidosis undergoing catheter ablation for atrial arrhythmias.
Heart Rhythm O2
August 2025
Cardiac Electrophysiology Section, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Background: Cardiac amyloidosis (CA) is characterized by atrial myopathy, which predisposes patients to atrial fibrillation (AF) and other atrial arrhythmias (AA). Although catheter ablation of AA is effective in the general population, its efficacy and safety in patients with CA remain unclear.
Objective: The study aimed to evaluate outcomes in patients with CA undergoing catheter ablation for typical atrial flutter (TAFL) and left atrial (LA) arrhythmias and to assess the presence and influence of LA low-voltage areas (LVA) in the latter.
Dual-atria rotor modification: A comparative analysis of rotor modification and posterior wall isolation in patients with persistent and long-standing persistent atrial fibrillation.
Heart Rhythm O2
August 2025
Division of Cardiology, Tokyo Metropolitan Ohkubo Hospital, Shinjyuku-ku, Tokyo, Japan.
Background: Various methods have been devised for catheter ablation of persistent atrial fibrillation (AF). However, it remains difficult to understand the mechanism of AF and to determine the optimal method.
Objective: This study aimed to evaluate the effectiveness of rotor modification (RM) compared to posterior wall isolation (PWI) in the treatment of persistent AF.