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Key Teaching Points  • Subcutaneous implantable cardioverter-defibrillators (SICDs) are effective for prevention of sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM). • New conduction abnormalities, especially left bundle branch block, may develop in HCM patients following septal reduction surgery and can result in T-wave oversensing (TWOS). Immediate interrogation of the SICD with update of templates following surgery is recommended. • Close monitoring of SICD sensor settings for up to several months after invasive treatment for HCM is suggested to identify TWOS and avoid inappropriate shocks.

heartrhythm case reports

Inappropriate shock from delayed T-wave oversensing by a subcutaneous implantable cardioverter-defibrillator after septal myectomy for hypertrophic cardiomyopathy