Transapical myectomy and surgical cryoablation for refractory ventricular tachycardia due to hypertrophic cardiomyopathy with apical aneurysm.

Ventricular tachycardia (VT) associated with midventricular hypertrophic cardiomyopathy and apical aneurysm is rare, but is frequently refractory to medical therapy. We report a case of a 44-year old man with incessant VT despite undergoing catheter ablation in the neck of a left ventricular apical aneurysm. Resection of a hypertrophied midventricular muscle through an apical incision and surgical cryoablation of the aneurysm border from the epicardial and endocardial surface were performed successfully. The patient was well without ventricular arrhythmic events at 2 years postoperatively.