Catheter Ablation for Ventricular Tachycardia in Patients With Hypertrophic Cardiomyopathy: Electrophysiological Characteristics and Long-Term Outcomes

Jin, S; Li, M; Jiang, C; Tang, R; Sang, C; Wang, W; Zhao, X; Li, C; Li, S; Guo, X; Jia, C; Ning, M; Feng, L; Wen, D; Zhu, H; Liu, T; Jiang, Y; Liu, F; Jiang, C; Zhou, N; Han, K; Yang, J; Long, D; Du, X; Dong, J; Ma, C

doi:10.1016/j.jacep.2025.05.028

Heart failure & cardiomyopathies

Catheter Ablation for Ventricular Tachycardia in Patients With Hypertrophic Cardiomyopathy: Electrophysiological Characteristics and Long-Term Outcomes

JACC Clin ElectrophysiolPublished 6 Aug 2025Observational cohort study

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Authors' conclusion

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.

Study context

Population: Patients with HCM-VT who underwent catheter ablation
Participants: 32 patients

Outcome: Site-specific electrophysiological properties and ablation outcomes

Main finding

As reported in the abstract

Combined endocardial/epicardial mapping: 29 of the 32 patients
Ventricular tachycardia (VTs) induced: 28 VTs among 25 patients: 25 scar-mediated re-entries, 2 focal origins, 1 bundle branch re-entry
Re-entry location: Left ventricular (LV) lateral wall: 9 of 25
Re-entry location: apical aneurysm: 6 of 25
Re-entry location: superior basal regions: 8 of 25
Re-entry location: interventricular septum: 1 of 25
Re-entry location: papillary muscle: 1 of 25
Incomplete activation, LV lateral wall (epicardium; endocardium): 54.3% ± 11.7%; 35.9% ± 15.5%
Incomplete activation, apical aneurysm (endocardium; epicardium): 40.3% ± 25.0%; 32.7% ± 22.6%
Incomplete activation, superior basal regions (endocardium; epicardium): 25.5% ± 7.7%; 27.2% ± 11.4%

Observational data: associations, not effects.

Further findings

Long-term VT-free survival after index procedure, by site · median follow-up 31 months

LV lateral wall: 73.3%
Apical aneurysm: 83.3%
LV superior basal region and septum: 0%

Consistent with the extent of mid-myocardial involvement

VT-free survival after multiple procedures, all patients · median follow-up 31 months

All patients: 71.9%

Original publication

Catheter Ablation for Ventricular Tachycardia in Patients With Hypertrophic Cardiomyopathy: Electrophysiological Characteristics and Long-Term Outcomes. JACC Clin Electrophysiol. Published 6 August 2025. doi:10.1016/j.jacep.2025.05.028

Read the original article ↗

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