Key result
Extensive LGE and NSVT guide primary-prevention ICD placement in low-risk apical HCM.
Case Report (n=1)
No
This case illustrates that in patients with apical hypertrophic cardiomyopathy and a low calculated HCM Risk-SCD score (<4%), extensive late gadolinium enhancement (~25% LV mass) and serial arrhythmia monitoring detecting non-sustained ventricular tachycardia are critical for guiding primary-prevention ICD implantation.
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May support ICD consideration in apical HCM with extensive LGE/NSVT despite low Risk-SCD; leaves open validation in prospective cohorts.
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Radić et al. (2026) conducted a case report in Apical hypertrophic cardiomyopathy presenting with vasovagal syncope (n=1). Implantable cardioverter defibrillator (ICD) implantation was evaluated on Successful primary-prevention ICD implantation following detection of non-sustained ventricular tachycardia and extensive late gadolinium enhancement. Primary-prevention ICD implantation was performed in a 60-year-old man with apical hypertrophic cardiomyopathy, 25% LGE, and NSVT despite an HCM Risk-SCD score <4%.
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