Long-Term Follow-Up of Hypertrophic Cardiomyopathy Patients With Implantable Cardioverter–Defibrillators

Contemporary strategies for risk stratification and prevention of sudden death with the implantable defibrillator in hypertrophic cardiomyopathy

“…Annual discharge rates were 5.5% overall, 11% secondary prevention (after cardiac arrest), and 4% primary prevention (≥ 1 major risk factor) ( Table 1). The ICD discharge rate of 4%/year in HCM has been reproduced in several other diverse populations in Europe, Australia and Canada (Table 1), [32][33][34][35][36][37] and is similar to that reported for SD in the pre-ICD era from tertiary referral centers. 2,3,12,21 Notably, appropriate discharge rates do not differ significantly among patients implanted for 1, 2 or ≥ 3 risk factors ( Figure 3A), 6 Also, about one-third of patients with appropriate interventions were implanted for only one marker (most commonly unexplained syncope) underscoring that a single strong established risk factor considered major in the clinical profile of an individual patient may be sufficient to regard SD risk unacceptably increased and consider an ICD for primary prevention.…”