Key result
Dual-coil ICD lead enables successful defibrillation in severe Danon disease hypertrophic cardiomyopathy.
Case Report (n=1)
In patients with Danon disease and extreme myocardial hypertrophy, standard single-coil ICDs may fail to defibrillate, highlighting the potential necessity for dual-coil systems.
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May necessitate dual-coil ICDs for VF termination in Danon extreme HCM; case report leaves open need for validation.
A prospective observation for 4 years (from 14 to 17 years) is presented for a girl with Danone’s disease. The early onset of the disease was noted, the clinical picture was dominated by syncopal and syncopal conditions. According to the clinical picture, presyncopal conditions were of a vasovagal nature, which was verified by the results of the Tilt test when the vasodepressor variant was detected. The disease was characterized by isolated cardiac disorders in the form of concentric hypertrophic cardiomyopathy, widespread fibrous changes in the myocardium. According to the standard ECG and daily ECG monitoring, ventricular preexitation syndrome was detected. Electrophysiological examination established the nodo-ventricular tract. Myopathy, cognitive impairment and visual changes were absent. A mutation in the heterozygous state was detected in exon 5 of 9 exons of the LMP2 gene, leading to the acquisition of a premature stop codon, was identified. X:g.119581719G>A ENST00000434600.2: c.718C>T. The mutation was verified by Sanger. The case in the pedigree is sporadic. As a prevention of sudden cardiac death, implantation of a cardioverter-defibrillator was performed. Effective relief of induced stable ventricular fibrillation (Burst stimulation protocol) was achieved only with the use of a ventricular electrode with two shock coils.
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Leontyeva et al. (2023) conducted a case report in Danon disease with hypertrophic cardiomyopathy (n=1). Implantable cardioverter-defibrillator (ICD) was evaluated on Relief of induced stable ventricular fibrillation. Implantation of an ICD with a dual-coil ventricular lead was required for effective relief of induced stable ventricular fibrillation in a girl with Danon disease and extreme hypertrophic cardiomyopathy.
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