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A hybrid ARQ scheme exploiting the concatenated two-state trellis-coded modulation (CT-TCM) coding gain is proposed in this paper. This scheme involves multiple simple component TCM codes that are heavily punctured before transmission. The different punctured parts are used for retransmission and provide improved coding gain after being combined at the receiver. We demonstrate by simulations that our CT-TCM-based hybrid ARQ can achieve higher efficiency than existing schemes.