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Successful epicardial ablation for ventricular tachycardia originating from the true apex of apical aneurysm associated with hypertrophic cardiomyopathy
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  • Motoki Nakao,
  • Masaya Watanabe,
  • Rui Kamada,
  • Hikaru Hagiwara,
  • Yumi Takahashi,
  • Taro Koya,
  • Takehide Kadosaka,
  • Takuya Koizumi,
  • Masanori Hirose,
  • Toshihisa Anzai
Motoki Nakao
Hokkaido University School of Medicine
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Masaya Watanabe
Hokkaido University School of Medicine
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Rui Kamada
Hokkaido University School of Medicine
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Hikaru Hagiwara
Hokkaido University School of Medicine
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Yumi Takahashi
Hokkaido University School of Medicine
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Taro Koya
Hokkaido University School of Medicine
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Takehide Kadosaka
Hokkaido University School of Medicine
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Takuya Koizumi
Hokkaido University School of Medicine
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Masanori Hirose
Hakodate Goryokaku Hospital
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Toshihisa Anzai
Hokkaido University School of Medicine
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Abstract

Hypertrophic cardiomyopathy (HCM) with apical aneurysm (AA) is rare, but have been reported to be associated with refractory ventricular tachycardias (VTs). Majority of such cases had a central isthmus of the reentry circuit on the border zone of AA. In this report, we describe a rare case of the successful epicardial ablation for a refractory VT originating from a true apex of the aneurysm in a HCM patient. Mid-diastolic potential during sustained VT was recorded at the isolated epicardial myocardium surround by the gross unexcitable scar in AA, and radiofrequency current application rendered VT non-inducible.