Ventricular Tachyarrhythmias in Patients With Hypertrophic Cardiomyopathy and Defibrillators: Triggers, Treatment, and Implications

Link, Mark S.; Bockstall, Katy; Weinstock, Jonathan; Alsheikh‐Ali, Alawi A.; Semsarian, Christopher; Estes, N.A. Mark; Spirito, Paolo; Haas, Tammy S.; Rowin, Ethan J.; Maron, Martin S.; Maron, Barry J.

doi:10.1111/jce.13194

Cited by 45 publications

(29 citation statements)

References 28 publications

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“…The success rate of ATP for MM VTs in this study population was 69%. This finding is consistent with previous data in HCM as well as in non‐HCM patients …”

Section: Discussionsupporting

confidence: 94%

“…This finding is consistent with previous data in HCM 5 20 and intracardiac VT morphology. 21 In our study population, VT cycle length, ATP pacing rate, cycle length variability, and EGM-morphology did not predict ATP efficacy.…”

Section: Atp Efficacysupporting

confidence: 94%

“…In agreement with a previous study, 5 MM VTs were the most common arrhythmia triggering ICD intervention. However, as a result of ICD programming, time to first ATP was extremely short.…”

Section: Burden Of Ventricular Arrhythmia Suitable For Atpsupporting

confidence: 93%

“…[1][2][3][4] Previous studies in HCM patients reported on the burden of ventricular arrhythmia (VA) suitable for ATP and the success rate of appropriately delivered ATP for MM VTs. 5 However, estimating the clinical value of ATP requires considering efficacy and safety of ATP delivered for both appropriately and inappropriately detected arrhythmia. This issue is presently unaddressed in HCM patients.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of anti‐tachycardia pacing in patients with hypertrophic cardiomyopathy implanted with an ICD

Adduci

Semprini

Palano

et al. 2019

Pacing Clinical Electrophis

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Background In hypertrophic cardiomyopathy (HCM) patients implanted with an implantable cardioverter defibrillator (ICD), clinical outcomes of antitachycardia pacing (ATP) have been poorly explored. In a retrospective analysis of a cohort of consecutive HCM patients implanted with an ICD, we aimed to assess the efficacy, safety, and clinical value of ATP. Methods The cohort of HCM patients implanted with a transvenous ICD and followed in our center was assessed for device intervention from implantation to last clinical follow‐up. Results Overall 77 patients (45 males; mean age: 46 ± 16 years) were analyzed. After 67 ± 41 months, 24 patients had 49 ventricular tachycardia/fibrillation (VT/VF) appropriately treated (5.8% per year). Among 39 monomorphic VTs, ATP was effective in 27 (success rate: 69%). Mean time from VT onset to ATP delivery was 9.1 ± 4.9 s. The only clinical variable improving ATP success was use of beta‐blockers (81% vs 50%; P = .04). Out of 12 ineffectively treated VTs, one was immediately shocked, four self‐terminated after 18 ± 12 s, and seven (18%) were accelerated to a new VT. ATP was also delivered for 27 of 42 inappropriately detected episodes and induced two de novo VTs (7%). In the per patient analysis, 14 out 77 (18%) patients had one or more appropriate and effective ATP (3.4% per year), and only six (8%; 1.4% per year) received more than one ATP. Conclusion ATP is moderately effective for the treatment of monomorphic VTs in HCM patients. However, the rate of appropriate ATP therapies is low, ATP is often prematurely delivered, and ATP‐induced arrhythmia degeneration is of concern.

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“…The success rate of ATP for MM VTs in this study population was 69%. This finding is consistent with previous data in HCM as well as in non‐HCM patients …”

Section: Discussionsupporting

confidence: 94%

Section: Atp Efficacysupporting

confidence: 94%

“…In agreement with a previous study, 5 MM VTs were the most common arrhythmia triggering ICD intervention. However, as a result of ICD programming, time to first ATP was extremely short.…”

Section: Burden Of Ventricular Arrhythmia Suitable For Atpsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety and efficacy of anti‐tachycardia pacing in patients with hypertrophic cardiomyopathy implanted with an ICD

Adduci

Semprini

Palano

et al. 2019

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…In a study of 71 HCM individuals with ICD for primary or secondary prevention, ventricular fibrillation or rapid VT episodes (>200 bpm) were more frequently preceded by supraventricular rhythms greater than 100 bpm ( p = 0.001) suggesting that supraventricular tachycardia might play a role in the trigger of rapid VT 46 .…”

Section: Risk Factors and Modifiersmentioning

confidence: 99%

Hypertrophic cardiomyopathy: Sudden cardiac death risk stratification in adults

Jordà

García‐Álvarez

2018

gcsp

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[first paragraph of article]Sudden cardiac death (SCD) is a devastating and often unpredictable complication of hypertrophic cardiomyopathy (HCM) that may occur as the initial disease presentation, frequently in asymptomatic or mildly symptomatic young people. Until 2000, only small series of patients examining predictors of SCD had been published, with a selection bias towards severe disease. Subsequently, larger series that are more representative of the HCM spectrum have shown that the annual SCD rate is less than 1%, and that there are subgroups of patients with a clearly higher risk.

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Ventricular Tachycardia with Structural Heart Disease

Ding

Yao

2019

Cardiac Electrophysiology Without Fluoroscopy

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Ventricular Tachyarrhythmias in Patients With Hypertrophic Cardiomyopathy and Defibrillators: Triggers, Treatment, and Implications

Cited by 45 publications

References 28 publications

Safety and efficacy of anti‐tachycardia pacing in patients with hypertrophic cardiomyopathy implanted with an ICD

Safety and efficacy of anti‐tachycardia pacing in patients with hypertrophic cardiomyopathy implanted with an ICD

Hypertrophic cardiomyopathy: Sudden cardiac death risk stratification in adults

Ventricular Tachycardia with Structural Heart Disease

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