A Case of Refractory Sustained Ventricular Tachycardia with Dilated-Phase Hypertrophic Cardiomyopathy Treated by Left Ventriculotomy
10.4326/jjcvs.36.184
- VernacularTitle:拡張相肥大型心筋症による難治性心室頻拍に対し心筋切除術が著効した１例
- Author:
Kenta Izumi
;
Kiyoyuki Eishi
;
Kouji Hashizume
;
Seiichi Tada
;
Kentaro Yamane
;
Hideaki Takai
;
Kazuyoshi Tanigawa
;
Takashi Miura
;
Shun Nakaji
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2007;36(4):184-187
- CountryJapan
- Language:Japanese
-
Abstract:
A 63-year-old man had been receiving medical treatment for hypertrophic cardiomyopathy (HCM) for 20 years. Sustained ventricular tachycardia (VT) had often occurred over the previous 2 years in spite of the administration of antiarrhythmic drugs. He therefore received an implantable cardioverter defibrillator (ICD). However, his symptoms did not improve thus dilated-phase HCM was diagnosed. Because sustained VT often occurred subsequently, the ICD had to be frequently used. An electrophysiological study (EPS) using the CARTO electroanatomical mapping system revealed the earliest activation site to be in the posterolateral wall of the left ventricle (LV). VT did not stop despite 2 endocardial catheter ablation procedures. Therefore, the VT foci was thought to be a reentry circuit on the epicardial side of the posterolateral LV wall. A part of the posterolateral LV wall that involved the reentry circuit was therefore resected. Since undergoing this surgical procedure, the patient has experienced no recurrence of VT during a follow-up period of 14 months.
