Effectiveness of implantable cardioverter defibrillator as primary prevention in hypertrophic cardiomyopathy: One year follow-up study

Background: Hereditary hypertrophic cardiomyopathy (HCM) is characterized by unexplained left ventricular hypertrophy and varied clinical manifestations. The worst outcome of this disorder, ventricular fibrillation, is sudden cardiac death (SCD), hence the only effective treatment is an implanted cardioverter-defibrillator (ICD). Objective: ICD as a significant preventative technique for hypertrophic cardiomyopathy to avoid sudden cardiac death, study ICD shock risk factors and predictors, ICD suitable shock and their predictions. Method: In an observational, prospective cohort trial, 33 consecutive men and women got ICD treatment to prevent HCM. Patients aged 35-64 were examined at Ibn Al Bitar Specialist Center for Heart Surgery in 2017 for one-year follow-up. At ICD programming visits, all patients had transthoracic echocardiography and were compared to a previous echo exam. Results: 33 patients completed the investigation, with a mean age of 46.5 +/- 7.1, lowest age 35, highest age 64, and 1.2:1 male-to-female ratio. Non-sustained VT on Holter, family history of sudden cardiac death, repeated syncope episodes, and left ventricular wall thickness <30mm increased ICD implantation. 24.2% had two risks, 12.1% three, and 63.6% one. 36.4% positive ICD treatment, all ATP, and all shocks were tested. 27.3% had excellent ICD shock. Women experienced more ICD shocks than men regardless of age. SCD and syncope in the family elevated ICD shock rates. ICD shock risk was higher in women, repeated syncope, and sudden cardiac death families. ICD treatment helps younger patients, those with a positive family history of sudden cardiac death, non-sustained VT, and larger left ventricular outflow tract diameters. Conclusion: ICD shock is more frequent in women with a family history of SCD, syncope, and numerous risk factors. HCM patients with one risk factor may get an ICD as primary prevention. Several risk factors increase ICD shock risk. Inappropriate shock is linked to advanced age and decreased left ventricular outflow tract.