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June 27, 2026EP EuropaceOpen Access

An ESC SCD risk score of ≥6% was significantly associated with subsequent ICD therapy (OR 11, 95% CI 1.48 to 81.6, p=0.019), whereas genetic variants and extensive LGE scar did not predict ICD therapy.

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Why the study?

Identifying which patients with HCM are most at risk of ventricular arrhythmias may help guide the decision to implant an ICD.

Does an ESC sudden cardiac death risk score ≥6% or the presence of a genetic variant predict ventricular arrhythmias and ICD therapy in patients with hypertrophic cardiomyopathy?

Population

73 HCM patients at a single centre

Design

Single-centre retrospective cohort study

Follow-up

Median 5 years 5 months (IQR 3 years - 9 years)

Authors

HMH MooreOBO BasquillGFG Furniss

Discussion

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Overview

May flag higher-risk patients for closer monitoring; hypothesis-generating in small observational data and needs prospective validation.

Key Points

  • This study aims to identify characteristics of hypertrophic cardiomyopathy patients at risk for ventricular arrhythmias after ICD implant and the role of genetic variants.
  • Identified cases of hypertrophic cardiomyopathy using electronic databases.
  • Reviewed electronic health records for demographics, left ventricular outflow tract gradient, SCD risk score, genotype, and ICD therapy.
  • Analyzed predictors of ventricular arrhythmias based on ESC guidelines.
  • 73 patients with HCM identified; 36 underwent genetic testing, with 44% finding genetic variants.
  • The strongest predictor for ICD therapy was an ESC risk score of 6% or more (OR 11, 95% CI 1.48-81.6, p=0.019).
  • An average age at diagnosis was earlier for patients with a genetic variant (46 years) compared to those without (56 years), p=0.007.

Structured PICO

Does an ESC sudden cardiac death risk score ≥6% or the presence of a genetic variant predict ventricular arrhythmias and ICD therapy in patients with hypertrophic cardiomyopathy?

P
Population
73 patients with hypertrophic cardiomyopathy (HCM), mean age 60 ± 12, 63% male.
O
Outcome
Ventricular arrhythmias requiring ICD therapy (shock or anti-tachycardia pacing)hard clinical

An ESC sudden cardiac death risk score of ≥6% is a strong predictor of appropriate ICD therapy in patients with hypertrophic cardiomyopathy, supporting current guideline recommendations for shared decision making.

Limitations

  • Small sample size

Cite This Study

Moore et al. (2026) studied this question.

synapsesocial.com/papers/6a3f97bb125782b61d865926https://doi.org/10.1093/europace/euag105.929
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