A prophylactic implantable cardioverter-defibrillator successfully restored sinus rhythm after an unprovoked episode of ventricular fibrillation in a 20-year-old man with hypertrophic cardiomyopathy.
Case Report (n=1)
Does a prophylactic ICD prevent sudden cardiac death in an asymptomatic patient with hypertrophic cardiomyopathy and extreme hypertrophy as the sole risk factor?
Prophylactic ICD placement in an asymptomatic HCM patient with extreme hypertrophy as the sole risk factor successfully aborted a sudden cardiac death event from ventricular fibrillation.
A 20-year-old asymptomatic man was diagnosed with hypertrophic cardiomyopathy (HCM) after routine physical examination during which a systolic heart murmur was detected. Echocardiography showed massive left ventricular (LV) hypertrophy with ventricular septal thickness of 36 mm extending into the anterolateral wall (30 mm); outflow obstruction was absent. Ambulatory (Holter) ECG showed 3 isolated premature ventricular contractions, and blood pressure response to exercise was normal. Echocardiographic examinations in parents and siblings were negative for HCM. Although 2 centers advised against an implantable cardioverter-defibrillator (ICD) based on the presence of only 1 risk factor for sudden death (ie, extreme hypertrophy), a prophylactic device was recommended by a third cardiac consultant. After an uneventful 16-month period during which the ICD neither detected nor treated arrhythmias, an unprovoked episode of ventricular fibrillation triggered a defibrillation shock that immediately restored sinus rhythm (Figure
Maron et al. (Tue,) conducted a case report in Hypertrophic cardiomyopathy (n=1). Implantable cardioverter-defibrillator (ICD) was evaluated on Ventricular fibrillation and defibrillation shock. A prophylactic implantable cardioverter-defibrillator successfully restored sinus rhythm after an unprovoked episode of ventricular fibrillation in a 20-year-old man with hypertrophic cardiomyopathy.