Implantable defibrillator placement in a 48-year-old woman with nonobstructive HCM resulted in an appropriate shock for ventricular fibrillation just 3 hours and 20 minutes post-implantation.
Case Report (n=1)
Early appropriate ICD shocks can occur very shortly after implantation in patients with hypertrophic cardiomyopathy due to the underlying arrhythmogenic substrate.
INTRODUCTION: Implantable defibrillators have proved effective in terminating potentially life-threatening ventricular tachyarrhythmias in hypertrophic cardiomyopathy (HCM), although the timing of appropriate shocks may be exceedingly variable. METHODS AND RESULTS: We report an unusual occurrence in a 48-year-old woman with nonobstructive HCM who experienced an appropriate shock for ventricular fibrillation only 3 hours and 20 minutes after implantation. Careful review of the clinical circumstances failed to define a specific mechanism related to the implant procedure that could have triggered the potentially lethal arrhythmia. CONCLUSION: Early device interventions are not uncommon in HCM, but (as in this case) appear unrelated to mechanisms other than the unpredictable and underlying arrhythmogenic substrate in this disease.
Almquist et al. (2007) conducted a case report in Hypertrophic Cardiomyopathy (n=1). Implantable defibrillator was evaluated on Appropriate shock for ventricular fibrillation. Implantable defibrillator placement in a 48-year-old woman with nonobstructive HCM resulted in an appropriate shock for ventricular fibrillation just 3 hours and 20 minutes post-implantation.