Primary Prevention of Sudden Death as a Novel Treatment Strategy in Hypertrophic Cardiomyopathy
Key result
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.
Why the study?
Does a prophylactic ICD prevent sudden cardiac death in an asymptomatic patient with hypertrophic cardiomyopathy and extreme hypertrophy as the sole risk factor?
Population
20-year-old asymptomatic man with hypertrophic cardiomyopathy and massive left ventricular hypertrophy…
Design
Case_report
Follow-up
16 months
Authors
Discussion
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Implication
May support individualized prophylactic ICD consideration in asymptomatic HCM with extreme hypertrophy; leaves open need for randomized data.
Key Points
- To assess the efficacy of primary prevention strategies in preventing sudden death in a young patient with hypertrophic cardiomyopathy.
- Patient diagnosed via routine examination, echocardiography, and Holter ECG.
- Ambulatory monitoring indicated isolated premature ventricular contractions without obstructive symptoms.
- Consultations led to the recommendation of an implantable cardioverter-defibrillator despite limited risk factors.
- The patient remained asymptomatic for 16 months with no arrhythmias detected by the device.
- An unprovoked ventricular fibrillation episode occurred, successfully treated by the defibrillator, restoring sinus rhythm.
Study Design
Type
Case Report (n=1)
Structured PICO
Does a prophylactic ICD prevent sudden cardiac death in an asymptomatic patient with hypertrophic cardiomyopathy and extreme hypertrophy as the sole risk factor?
P
Population
20-year-old asymptomatic man with hypertrophic cardiomyopathy (HCM) and massive left ventricular hypertrophy (ventricular septal thickness 36 mm, anterolateral wall 30 mm) without outflow obstruction.
I
Intervention
Prophylactic implantable cardioverter-defibrillator (ICD)
O
Outcome
Ventricular fibrillation triggering a defibrillation shockhard clinical
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.
Cite This Study
Maron et al. (2003) 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.