Exercise-induced ventricular arrhythmias and risk of sudden cardiac death in patients with hypertrophic cardiomyopathy
Key result
Exercise-induced ventricular arrhythmias in patients with hypertrophic cardiomyopathy were independently associated with an increased risk of sudden death or ICD discharge (HR 3.14; 95% CI 1.29-7.61).
Why the study?
Does exercise-induced ventricular arrhythmia increase the risk of sudden cardiac death or ICD discharge in patients with hypertrophic cardiomyopathy?
Population
1,380 patients with hypertrophic cardiomyopathy referred to a cardiomyopathy clinic in London, UK, mean age…
Comparison
Exercise-induced ventricular arrhythmias vs Patients without exercise-induced ventricular…
Design
Cohort
Follow-up
mean 54 months
Authors
Discussion
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Member takes
Implication
May refine HCM sudden-death risk stratification; leaves open whether suppression improves outcomes or warrants practice change.
Study Design
Type
Cohort (n=1,380)
Multicenter
No
Structured PICO
Does exercise-induced ventricular arrhythmia increase the risk of sudden cardiac death or ICD discharge in patients with hypertrophic cardiomyopathy?
P
Population
1,380 patients with hypertrophic cardiomyopathy referred to a cardiomyopathy clinic in London, UK, mean age 42 years, 62% male.
I
Intervention
Exercise-induced ventricular arrhythmias (non-sustained ventricular tachycardia or ventricular fibrillation during upright exercise testing)
C
Comparator
Patients without exercise-induced ventricular arrhythmias
O
Outcome
Composite of sudden death, ICD discharge, or transplantcomposite
Main Result
Effect estimate: HR 3.14 (95% CI 1.29-7.61)
Absolute Event Rate: 29.6% vs 11.1%
p-value: p=0.01
Exercise-induced ventricular arrhythmias are rare in hypertrophic cardiomyopathy but independently predict an increased risk of sudden cardiac death or appropriate ICD discharge.
Cite This Study
Gimeno et al. (2009) conducted a cohort in hypertrophic cardiomyopathy (n=1,380). Exercise-induced ventricular arrhythmias (NSVT/VF) vs. No exercise-induced NSVT/VF was evaluated on death or cardiac event (sudden death, ICD discharge, or transplant) / sudden death or ICD discharge (HR 3.14, 95% CI 1.29-7.61, p=0.01). Exercise-induced ventricular arrhythmias in patients with hypertrophic cardiomyopathy were independently associated with an increased risk of sudden death or ICD discharge (HR 3.14; 95% CI 1.29-7.61).