Successful epicardial ablation for ventricular tachycardia originating
from the true apex of apical aneurysm associated with hypertrophic
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.