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Arrhythmias in Hypertrophic Cardiomyopathy
Author(s) -
STEWART JAMES T.,
McKENNA WILLIAM J.
Publication year - 1991
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1991.tb01354.x
Subject(s) - medicine , amiodarone , cardiology , hypertrophic cardiomyopathy , ventricular tachycardia , atrial fibrillation , sudden death , cardiomyopathy , implantable cardioverter defibrillator , ventricular fibrillation , sudden cardiac death , ambulatory , heart failure
Arrhythmias in Hypertrophic Cardiomyopathy. Arrhythmias, particularly atrial fibrillation and nonsustained ventricular tachycardia, are common in adult patients with hypertrophic cardiomyopathy. Atrial fibrillation has long been thought to herald an ominous prognosis, but this is probably not the case, and in the majority of patients atrial fibrillation can be controlled without accelerated symptomatic deterioration. Uncontrolled observations indicate that low dose amiodarone may be the most useful drug in paroxysmal and chronic atrial fibrillation. The detection of nonsustained ventricular tachycardia on ambulatory electrocardiogram monitoring remains the single most useful indicator of the risk of sudden death in the adult patient, and the treatment of choice is again low dose amiodarone. The mechanism of sudden death, and the mode of action of amiodarone in preventing it, are not known for certain in the majority of patients. The risk of sudden death is higher in children and adolescents, but arrhythmias are less common, and no useful predictive marker of increased risk has been found. The role of invasive electrophysiological studies and the place of the implantable cardioverter‐defibrillator in hypertrophic cardiomyopathy have not yet been established.