Purpose: To retrospectively analyse the risk of SCD and ICD therapies delivered in patients with HCM at our Hospital, Malta.
Method: Data Collection was done using IT systems used in the Department of Cardiology (CVIS). The HCM Risk-SCD calculator was used appropriately to calculate risk of SCD at 5 years.
Results: Locally, 19 patients with HCM have had an ICD inserted. 69% were males and 31% were females. The mean age at device implantation was 50 years. ICDs were inserted in 2 patients <16years of age, in 1 patient with Fabry’s disease and in 3 patients for secondary prevention. For the other 13 patients, the HCM Risk SCD calculator was used to calculate risk of SCD at 5 years. 5 patients had >6% risk of SCD at 5 years meaning that ICD insertion should be considered whereas 8 patients had 4-6% risk of SCD at 5 years meaning that ICD insertion may be considered. Cardiac MRI was used in most borderline cases to decide regarding ICD insertion. 15.7% (n=3) had appropriate therapies for VT; n=2 had SCD risk>6% and n=1 had SCD risk 4-6% (SCD risk 5.92%) at 5 years. One patient received anti-tachypacing (ATP) and shock therapies whereas the other two patients received only ATPs. 15.7% (n=3) had inappropriate therapies for AF. 15.7% (n=3) had complications related to device insertion including upper limb thrombosis, upper limb swelling and lead dislodgement.
Conclusion: ICD therapies are effective in terminating ventricular arrhythmias leading to SCD in patients with HCM. Identifying patients at risk of SCD is still an ongoing challenge. 15.7% have received appropriate therapies for VT.