Ablation of ventricular tachycardia after septal myectomy for hypertrophic cardiomyopathy

Surgical septal myectomy can achieve both of these goals. 1 While there is some suggestion that surgical myectomy may offer some protection against ventricular arrhythmia, one study of postseptal myectomy patients with implantable defibrillators suggested a 4%/year rate of appropriate defibrillator shocks. 2 Mechanisms of ventricular arrhythmia postseptal myectomy have not been reported. Because of the absence of risk factors for sudden death an implantable defibrillator was not offered postmyectomy. Pace mapping in the region of patchy scar adjacent to the septal myectomy demonstrated a 96% pacematch to the clinical VT with a short stimulus to QRS suggesting pacing at the exit site for the VT.