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Analysis of ICD therapies in patients with hypertrophic cardiomyopathy

Session Poster Session 4

Speaker Lisa Lauren Buttigieg

Congress : Heart Failure 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Hypertrophic Cardiomyopathy
  • Session type : Poster Session
  • FP Number : P2148

Authors : L L Buttigieg (Malta,MT), M Zammit Burg (Malta,MT), T Felice (Malta,MT)

L L Buttigieg1 , M Zammit Burg1 , T Felice1 , 1MaterDei Hospital, MaterDei Hospital - Malta - Malta ,


Background: Patients suffering from Hypertrophic cardiomyopathy (HCM) are at an increased risk of sudden cardiac death (SCD). In Malta, there are approximately 150 patients with HCM being followed-up at the Inherited Cardiomyopathy Clinic of which 19 have had an Implantable Cardioverter Defibrillator (ICD) implanted. 

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‚Äôs 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.

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