Acta clinica Croatica, Vol. 44 No. 4, 2005.
Izlaganje sa skupa
Which Patients with Hypertrophic Cardiomyopathy Should Receive a Cardioverter Defibrillator?
Dubravko Petrač
Sažetak
Ventricular tachyarrhythmias are the most common cause of sudden cardiac death in hypertrophic cardiomyopathy. Cardioverter defibrillator (ICD) therapy therefore presents a reasonable concept of improving prognosis in selected patients with hypertrophic cardiomyopathy. Recently published studies have confirmed this concept and demonstrated that ICD therapy provides life-saving protection by effectively terminating ventricular tachycardia or fibrillation in patients with hypertrophic cardiomyopathy. Since hypertrophic cardiomyopathy has a low risk of sudden cardiac death in the general population, the decision to implant an ICD depends on the patient symptoms and level of risk. ICD is strongly warranted for secondary prevention of sudden death in patients who have survived cardiac arrest or spontaneous sustained ventricular tachycardia. Because the presence of two or more risk factors confers an annual mortality rate of sudden death of 3%-6% or more, their presence in patients with hypertrophic cardiomyopathy justifies prophylactic therapy with ICD for primary prevention of sudden death. Decisions regarding prophylactic ICD therapy in patients with a single risk factor should be individualized depending on patient age and perceived risk factor severity. A young patient with an extreme left ventricular hypertrophy or a family history of sudden death due to hypertrophic cardiomyopathy should be considered as a candidate for ICD, or should be informed on the potential life-saving protection offered by ICD.
Ključne riječi
Cardiomyopathy - therapy; Defibrillators - implantable; Cardiovascular diseases - complications; Risk factors
Hrčak ID:
15743
URI
Datum izdavanja:
1.12.2005.
Posjeta: 2.506 *