International Practice Patterns in the Detection and Management of Arrhythmias in Patients With Hypertrophic Cardiomyopathy

trial fibrillation (AF) occurs in 22% to 32% of patients with hypertrophic cardiomyopathy (HCM), 1,2 with ≈50% experiencing subclinical/ asymptomatic AF on cardiac rhythm monitoring devices, including implantable loop recorders, implantable cardioverter-defibrillators (ICDs), and permanent pacemakers.3 Nonsustained ventricular tachycardia (NSVT) is associated with a higher risk of sudden cardiac death in patients with HCM. 4 Faster, longer, and repetitive episodes of NSVT may confer greater risk.5 Current guidelines do not directly address the role of different arrhythmia screening strategies (screening frequency, role of extended monitoring, wearable devices) and optimal management of detected arrhythmias.We conducted an international multicenter survey to evaluate practice patterns and expert opinions regarding AF and NSVT screening and management at HCM comprehensive care centers. 1 Survey questions were developed by experts with established practices in cardiac electrophysiology (ZL and AWS) and HCM (AWS, KO, and JG).The current study was approved by the University of British Columbia (UBC) research ethics board.This survey was generated and distributed by the Canadian-hosted Qualtrics UBC Survey tool.This survey was anonymously and individually distributed to a predetermined list of 34 clinical experts working at HCM comprehensive care centers in North America, Australia, and Europe in May 2021.Informed consent was obtained at the beginning of the survey.Anonymized data underwent descriptive statistics and visualization using the survey tool.The data that support the findings of this study are available from the corresponding author on reasonable request.We received 23 full and 1 partial response (Table ), of 34, from experts in Canada (n=5), the United States (n=10), Germany (n=1), Denmark (n=1), Italy (n=1), Australia (n=1), Spain (n=1), Switzerland (n=1), and the United Kingdom (n=2).Most respondents (65.2%) had >10 years of practice experience.Each center evaluates a mean of 265 (SD, 165) new patients with HCM annually.Routine screening was performed by 87% of respondents.Most experts (78%) considered left atrial dilatation an important factor when considering screening.Consumer wearable devices were the third most used screening tool (56%) and 91% would