Arrhythmia in hypertrophic cardiomyopathy. I: Influence on prognosis.

TLDR

The study examined whether arrhythmias detected by 72‑hour Holter monitoring predict prognosis in 86 unselected hypertrophic cardiomyopathy patients. Patients underwent 72‑hour ambulatory ECG monitoring and were then followed for a mean of 2.6 years (range 1–4). During monitoring, 23 patients had supraventricular tachycardia and 24 had ventricular tachycardia (10 with >3 episodes); over follow‑up, 7 died suddenly, all of whom had frequent ventricular ectopy or VT, linking these arrhythmias to sudden death, while supraventricular arrhythmias were not predictive.

Abstract

In order to examine the association between arrhythmia and subsequent prognosis, 72-hour ambulatory electrocardiographic monitoring was performed in 86 unselected patients with hypertrophic cardiomyopathy. During monitoring 23 patients experienced at least one episode of supraventricular tachycardia and 24 had ventricular tachycardia (of whom 10 had more than three episodes). The patients were then followed for a mean of 2.6 years (range one to four). Seven patients died suddenly. Of these, five had exhibited multiform and paired ventricular extrasystoles and ventricular tachycardia. These arrhythmias were significantly associated with sudden death whereas supraventricular arrhythmias were not. The patients who died suddenly were older and had experienced more symptoms than the survivors, and three had a family history of hypertrophic cardiomyopathy and sudden death. This experience provides the basis for the assessment of treatment in patients with hypertrophic cardiomyopathy and serious ventricular arrhythmia.