Key result
Disopyramide lacks robust evidence for oHCM and remains a last resort for nonresponders.
Why the study?
Current pharmacologic treatments for symptomatic obstructive hypertrophic cardiomyopathy often rely on limited, nonrandomized data or expert opinion, warranting an appraisal of disopyramide.
Does disopyramide have a place in the management of symptomatic obstructive hypertrophic cardiomyopathy?
Does disopyramide have a place in the management of symptomatic obstructive hypertrophic cardiomyopathy?
Disopyramide lacks robust clinical evidence for oHCM and should be reserved as a last-resort therapy for patients who do not respond to other pharmacologic treatments and are not candidates for invasive therapies.
Answers are grounded in this paper and cite their sources.
Supports reserving disopyramide as last-resort therapy in obstructive HCM; leaves open need for prospective trials to define its role.
Hypertrophic cardiomyopathy (HCM) is a relatively common inherited cardiac disorder associated with a left ventricular hypertrophy that cannot be explained by another cardiac or systemic disorder. One of the core pathophysiology features is left ventricular outflow tract obstruction (obstructive HCM [oHCM]), and this pathology could lead to complications, including sudden cardiac death and heart failure. Current treatment strategies for symptomatic oHCM consist of historical pharmacologic agents that are often based on nonrandomized, limited data or expert opinion. This article presents a critical appraisal of disopyramide, one of the pharmacologic options available in Canada for managing oHCM. The author concludes that robust clinical evidence supporting the use of disopyramide in treating oHCM is lacking, and that disopyramide should be reserved as a last resort for nonresponders to pharmacologic treatment and for those in whom invasive therapies are not indicated.
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Corriveau et al. (2024) conducted a review in Obstructive Hypertrophic Cardiomyopathy (oHCM). Disopyramide was evaluated. Disopyramide lacks robust clinical evidence for treating obstructive hypertrophic cardiomyopathy and should be reserved as a last resort for nonresponders to other pharmacologic treatments.
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