Further improvements in clinical understanding and risk stratification are necessary to identify hypertrophic cardiomyopathy patients who are at high risk of sudden cardiac death.
The review highlights the challenges in risk stratification for sudden cardiac death in hypertrophic cardiomyopathy and notes the roles of low-dose amiodarone and ICDs in high-risk individuals.
Hypertrophic cardiomyopathy (HCM) is a familial myocardial disease caused by mutations in cardiac sarcomeric proteins. HCM is characterised by myocyte disarray and myocardial fibrosis. Most patients are largely asymptomatic but some are prone to a number of disease-related complications, the most problematic of which is sudden cardiac death. Diagnosing patients who are at risk has not been easy because of the clinical heterogeneity of the disease, the frequent absence of symptoms prior to sudden cardiac death and the relatively low disease prevalence and annual mortality rates. To date, both low-dose amiodarone and internal cardioverter/defibrillator implantation have been advocated in high-risk individuals. Further improvements in clinical understanding and risk stratification are necessary to identify HCM patients who are at high risk of sudden death.
Sachdev et al. (2002) conducted a review in Hypertrophic cardiomyopathy (HCM). Low-dose amiodarone and internal cardioverter/defibrillator implantation was evaluated on Sudden cardiac death. Further improvements in clinical understanding and risk stratification are necessary to identify hypertrophic cardiomyopathy patients who are at high risk of sudden cardiac death.
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