Hypertrophic cardiomyopathy with midcavitary obstruction: another substrate for ventricular tachycardia?

摘要

The importance of the anatomic substrate for the genesis of ventricular arrhythmias has become widely accepted. Ventricular tachycardia (VT) associated with myocardial infarction typically has a critical isthmus endocardially, near the border zone of the myocardial scar.VT associated with Chagastic cardiomyopathy was the first arrhythmia described to have a predominantly epicardial substrate. Monomor-phic VT associated with dilated nonischemic cardiomyopathy, previously considered uncommon, has now been recognized to originate from basal periannular left ventricular (LV) low-voltage zone, often with a mid-myocardial or epicardial exit. Arrhythmogenic right ventricular cardiomyopathy has been associated with a periannular right ventricular substrate, with a larger region of epicardial compared with endocardial scar.