Ventricular arrhythmias and sudden cardiac arrest in hypertrophic cardiomyopathy
- Perry M Elliott, MD
Perry M Elliott, MD
- Reader in Inherited Cardiovascular Disease
- University College, London
- William J McKenna, MD
William J McKenna, MD
- Section Editor — Myopericardial Disease
- Professor of Cardiology
- University College, London
- Section Editors
- Samuel Lévy, MD
Samuel Lévy, MD
- Section Editor — Cardiac Arrhythmias
- Professor of Cardiology
- University of Marseille, France
- Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
- Editor-in-Chief — Cardiovascular Medicine
- Section Editor — Coronary Heart Disease
- Section Editor — Myopericardial Disease
- Professor of Medicine
- Mayo Medical School
Hypertrophic cardiomyopathy (HCM) is an autosomal dominant genetic disease of the cardiac sarcomere, caused by mutations in one of several genes, most of which encode components of the contractile apparatus. (See "Genetics of hypertrophic cardiomyopathy".)
HCM is characterized by left ventricular hypertrophy of various morphologies, with a wide array of clinical manifestations and hemodynamic abnormalities (figure 1). Depending in part upon the site and extent of cardiac hypertrophy, HCM patients can develop one or more of the following abnormalities:
●LV outflow obstruction (see "Types and pathophysiology of obstructive hypertrophic cardiomyopathy")
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- END-STAGE DISEASE
- VENTRICULAR ARRHYTHMIAS
- Ventricular premature beats
- Nonsustained VT
- Sustained VT
- Medical treatment
- SUDDEN CARDIAC DEATH
- Identifying high-risk patients
- - Prior arrhythmic events
- - High-risk clinical features
- - Possible risk factors
- - Impact of number of risk factors
- - Low risk patients
- Physical activity and SCD
- Nonpharmacologic treatment of LVOT obstruction
- Evaluation and serial monitoring
- EP testing and ablation
- Antiarrhythmic drugs
- ICD prevention of SCD
- - ICD indications
- - ICD efficacy
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS
- Nonsustained ventricular arrhythmias
- Prevention of SCD
- - Physical activity restriction
- - ICD use