Ablation of the arrhythmogenic substrate in a patient with hypertrophic cardiomyopathy and Wolff-Parkinson-White syndrome who refused ICD therapy resulted in an uneventful 3-year follow-up on beta-blockers.
We present a young soldier presenting with aborted sudden cardiac death, who was found to have concomitant hypertrophic cardiomyopathy and Wolff-Parkinson-White syndrome. Along with pathological haemodynamic features of hypertrophic cardiomyopathy, an easily-inducible re-entrant tachycardia was clearly documented in our patient. Given the fatal potential of supraventricular tachycardia in hypertrophic cardiomyopathy, we postulated that his tachyarrhythmia could potentially trigger the event. Upon his refusal to receive implantable cardioverter/defibrillator therapy, we ablated anatomical arrhythmogenic substrate instead, and he remained uneventfully over 3 years on β-blocker.
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Kim et al. (2018) studied this question.
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