Abstract 19218: Prognosis of Apical Hypertrophic Cardiomyopathy in Patients With Implantable Cardioverter Defibrillators

Abstract

Aims: This Short Communication aims to identify the difference between the prognoses of apical and other types of hypertrophic cardiomyopathy (HCM) in patients with implantable cardioverter defibrillators (ICDs). Methods: We retrospectively analysed the database of our ICD clinic. All patients were implanted with ICDs from October 2006 to August 2017. We classified patients with HCM based on left ventricular (LV) outflow tract obstruction (LVOTO) and midventricular obstruction (MVO), in addition to apical HCM and other non-obstructive HCM types. Patient backgrounds, incidences of appropriate ICD therapies, hospitalizations for heart failure, electrical storms, and total deaths were examined. Results: A total of 64 consecutive Japanese patients with HCM and ICDs were enrolled in this study. The mean follow-up period was 86 ± 24 months, the mean age was 65 ± 14 years, and 83% of the patients were male. The LV ejection fraction was 56 ± 14%, the LV max wall-thickness was 19 ± 7 mm, 9.0% had LV apical aneurysms, and the HCM Risk-SCD was 4.4 ± 2.1. We classified the patients into two groups: 14 patients with apical HCM and 50 patients with other types of HCM. During the follow-up periods, there was no significant difference in the incidence of electrical storm, hospitalization for heart failure, and death between the 2 groups (p=0.11, p=0.60, p=0.39, respectively). Appropriate therapies occurred in 6 of 14 (43%) patients with apical HCM patients and 5 of 50 (10%) patients with other types of HCM (p=0.010). Conclusions: Compared with patients with other types of HCM, patients with apical HCM have a comparative prognosis, and treatment of ventricular arrhythmias should be strongly considered.