Highlights the risk of ICD sensing failure during ventricular fibrillation due to progressive electrical remodeling in patients with apical hypertrophic cardiomyopathy.
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Raises caution for ICD sensing failure in apical HCM with remodeling; leaves open optimal surveillance strategies.
Although there is a paucity of randomized trials evaluating outcomes after primary-prevention implantable cardioverter-defibrillator (ICD) placement for patients with hypertrophic cardiomyopathy, guidelines recommend ICD placement for certain patients with the disease.1 Apical hypertrophic cardiomyopathy (AHCM) is one pattern of disease manifestation with unique characteristics.2 Hypertrophy involves predominantly the apex of the left ventricle and at times the right ventricle. Whereas some have suggested a benign course of disease in cases of AHCM,3 there are a few reports of patients developing sustained ventricular arrhythmias and sudden cardiac death.
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Fleeman et al. (2016) studied this question.
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