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Hypertrophic cardiomyopathy: role of the implantable cardioverter-defibrillator.

Abstract：

OBJECTIVES:We report the occurrence of cardiac events during long-term follow-up in patients with hypertrophic cardiomyopathy (HCM) after cardioverter-defibrillator implantation. BACKGROUND:The identification of patients at high risk for sudden death and the prevention of recurrence of sudden death in HCM represents a difficult problem. METHODS:We retrospectively analyzed the occurrence of cardiac events during follow-up of 13 patients with HCM who received an implantable cardioverter-defibrillator (ICD) because of aborted sudden death (n = 10) or sustained ventricular tachycardia (n = 3) (group I). Findings were compared with those in 215 patients with an ICD and other structural heart disease or idiopathic ventricular fibrillation (group II). RESULTS:After a mean (+/-SD) follow-up period of 26+/-18 months, 2 of 13 patients in group I received appropriate shocks. The calculated cumulative incidence of shocks was 21% in group I and 66% in group II after 40 months (p < 0.05). We observed a low incidence of recurrence of ventricular tachycardia/fibrillation during follow-up in patients with HCM. No deaths occurred. CONCLUSIONS:Our data suggest that ventricular tachyarrhythmias may not always be the primary mechanism of syncope and sudden death in patients with HCM. The ICD seems to have a less important impact on prognosis in patients with HCM than in patients with other etiologies of aborted sudden death.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Primo J,Geelen P,Brugada J,Filho AL,Mont L,Wellens F,Valentino M,Brugada P

doi

10.1016/s0735-1097(98)00037-0

subject

Has Abstract

pub_date

1998-04-01 00:00:00

pages

1081-5

issue

5

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(98)00037-0

journal_volume

31

pub_type

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