The Portuguese Registry of Hypertrophic Cardiomyopathy: Overall results

Cardim, Nuno; Brito, Dulce; Lopes, Luís Rocha; Freitas, António; Araújo, Carla; Belo, Adriana; Gonçalves, Lino; Mimoso, Jorge; Olivotto, Iacopo; Elliott, Perry M.; Madeira, Hugo

doi:10.1016/j.repce.2018.02.008

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…(only 6% for bradyarrhythmia) and 13%, respectively, over an average follow up of 3.3 years. 22 Our study found much higher CIED implantation rates during a shorter period following ASA; 14% and 11% received PPM or ICD during the index hospitalization, respectively, and another 1% underwent CIED implantation over the ensuing 30 days. These disparate findings resulted from a slightly higher than average PPM implantation rate, failure of most prior studies to report index hospitalization ICD implantation rates 4,13,14 and much higher observed ICD implantation rates than anticipated.…”

Section: Discussionmentioning

confidence: 47%

Cardiac implantable electronic device placement following alcohol septal ablation for hypertrophic cardiomyopathy in the United States

Lam

Naidu

Kolte

et al. 2020

Cardiovasc electrophysiol

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Background: Cardiac implantable electronic devices (CIED) are sometimes required after alcohol septal ablation (ASA) for hypertrophic cardiomyopathy (HCM). The primary objectives of this study were to characterize the incidence, timing, and predictors of CIED placement after ASA for HCM. Methods: Patients were identified from the 2010-2015 Nationwide Readmissions Databases. Incidence, timing and independent predictors of CIED placement, as well as 30-day readmission rates were examined. Results: There were 1296 patients (national estimate = 2864) with HCM who underwent ASA. CIED were implanted in 322 (25% overall; 14% permanent pacemaker, 11% implantable cardioverter defibrillator) during the index hospitalization. Of these, 21%, 23%, 21%, and 18% occurred on postprocedure day 0, 1, 2, and 3, respectively. Only 17 (1.3%) patients underwent CIED implantation between discharge and 30-day follow up. Independent predictors of index hospitalization CIED implantation included older age, diabetes, heart failure, nonelective index hospital admission and hospitalization at a privately owned hospital. Nonelective 30-day readmission rates among those who did and did not undergo CIED placement during their index hospitalization, were 6.8% and 7.9%, respectively (p = .53); median time to readmission was also similar between groups. Conclusions: One in four HCM patients undergoing ASA underwent CIED implantation during their index hospitalization; nearly 2/3rd during the first 48 h postprocedure. Private hospital ownership independently predicted CIED placement. More data are needed to better understand the unexpectedly high rates of CIED placement, earlier than anticipated timing of implantation and differential rates by hospital ownership.

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Section: Discussionmentioning

confidence: 47%

Cardiac implantable electronic device placement following alcohol septal ablation for hypertrophic cardiomyopathy in the United States

Lam

Naidu

Kolte

et al. 2020

Cardiovasc electrophysiol

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“…As previously commented, so far few registry-based data have been published on CIED implants in HCM patients. In the Portuguese Registry of Hypertrophic Cardiomyopathy, over the years 2013-2015 the main indication (88%) for ICD was primary prevention; a pacemaker was implanted for conduction disorders in 70% of the patients and for gradient reduction in 21% [18]. Pacing therapy with atrioventricular sequential pacing can reduce LVOT obstruction and improve symptoms in obstructive HCM (HOCM) patients [19].…”

Section: Discussionmentioning

confidence: 99%

Cardiac implantable electrical devices in patients with hypertrophic cardiomyopathy: single center implant data extracted from the Swedish pacemaker and ICD registry

Valzania

Gadler

Boriani

et al. 2020

Scandinavian Cardiovascular Journal

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Objectives: To investigate cardiac implantable electrical device (CIED) first implants in patients with hypertrophic cardiomyopathy (HCM) in a Swedish tertiary university hospital. Design: Clinical and technical data on pacemaker, implantable cardioverter defibrillator (ICD), and cardiac resynchronization therapy (CRT) first implants performed in HCM patients at the Karolinska University Hospital from 2005 to 2016 were extracted from the Swedish Pacemaker and ICD Registry. Echocardiographic data were obtained by review of hospital recordings. Results: The number of first pacemaker implants in HCM patients was 70 (1.5% of total pacemaker implants). The mean age of HCM pacemaker patients was 71 ± 10 years. Pacemaker implants were almost uniformly distributed between genders. Dual-chamber pacemakers with or without CRT properties were prevalent (6 and 93%, respectively). The number of first ICD implants in HCM patients was 99 (5.1% of total ICD implants). HCM patients receiving an ICD were 53 ± 15 years and prevalently men (70%). Sixty-five (66%) patients were implanted for primary prevention. Dual-chamber ICDs with or without CRT were 21 and 65%, respectively. Obstructive HCM was present in 47% pacemaker patients and 25% ICD patients with available pre-implant echo. Conclusions: This retrospective registry-based study provides a picture of CIED first implants in HCM patients in a Swedish tertiary university hospital. ICDs were the most commonly implanted devices, covering 59% of CIED implants. HCM patients receiving a pacemaker or an ICD had different epidemiological and clinical profiles.

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“…24 A Portuguese registry of 1042 patients with HCM (mean age 53±16 years) also found that heart failure was the most common cause of death in older patients. 25 …”

Section: Hcm-related Scd In the Youngmentioning

confidence: 99%

Return to play with hypertrophic cardiomyopathy: are we moving too fast? A critical review

et al. 2021

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The diagnosis of a potentially lethal cardiovascular disease in a young athlete presents a complex dilemma regarding athlete safety, patient autonomy, team or institutional risk tolerance and medical decision-making. Consensus cardiology recommendations previously supported the ‘blanket’ disqualification of athletes with hypertrophic cardiomyopathy (HCM) from competitive sport. More recently, epidemiological studies examining the relative contribution of HCM as a cause of sudden cardiac death (SCD) in young athletes and reports from small cohorts of older athletes with HCM that continue to exercise have fueled debate whether it is safe to play with HCM. Shared decision-making is endorsed within the sports cardiology community in which athletes can make an informed decision about treatment options and potentially elect to continue competitive sports participation. This review critically examines the available evidence relevant to sports eligibility decisions in young athletes diagnosed with HCM. Histopathologically, HCM presents an unstable myocardial substrate that is vulnerable to ventricular tachyarrhythmias during exercise. Studies support that young age and intense competitive sports are risk factors for SCD in patients with HCM. We provide an estimate of annual mortality based on our understanding of disease prevalence and the incidence of HCM-related SCD in different athlete populations. Adolescent and young adult male athletes and athletes participating in a higher risk sport such as basketball, soccer and American football exhibit a greater risk. This review explores the potential harms and benefits of sports disqualification in athletes with HCM and details the challenges and limitations of shared decision-making when all parties may not agree.

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The Portuguese Registry of Hypertrophic Cardiomyopathy: Overall results

Cited by 5 publications

References 26 publications

Cardiac implantable electronic device placement following alcohol septal ablation for hypertrophic cardiomyopathy in the United States

Cardiac implantable electronic device placement following alcohol septal ablation for hypertrophic cardiomyopathy in the United States

Cardiac implantable electrical devices in patients with hypertrophic cardiomyopathy: single center implant data extracted from the Swedish pacemaker and ICD registry

Return to play with hypertrophic cardiomyopathy: are we moving too fast? A critical review

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