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A. Basics
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01. History of Cardiology
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Long-term follow-up of ICD therapies in hypertrophic cardiomyopathy: a large single centre experience
Session:
Painel 9 - Doença Valvular 7
Speaker:
Inês Grácio Almeida
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Inês Grácio De Almeida; Sílvia Aguiar Rosa; Pedro Silva Cunha; Bruno Tereno Valente; Guilherme Portugal; Ana Lousinha; André Viveiros Monteiro; Madalena Coutinho Cruz; Ana Sofia Delgado; Mário Martins Oliveira; Rui Cruz Ferreira
Abstract
<p><strong>Introduction: </strong>Hypertrophic cardiomyopathy (HCM) is associated with a high risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD), treatable with an implantable cardioverter defibrillator (ICD).</p> <p><strong>Objective: </strong>Evaluation of indications for ICD in HCM patients (P) and outcomes during a long-term follow-up (FU) after implantation.</p> <p><strong>Material and methods: </strong>Retrospective analysis of consecutive HCM P submitted to ICD implantation in a tertiary centre between 1996 and 2018. Characterization of clinical indications for ICD, long-term evaluation of ICD performance and total mortality.</p> <p><strong>Results:</strong> 66P were enrolled (47.7±18.2 years, 72.7% male). In 74.2%, ICD was implanted for primary prevention, mainly based on HCM risk-SCD score (mean 6.7±1.8%; 66.7% >6%). Familial history of SCD was present in 51.5%, non-sustained (NS) ventricular tachycardia (VT) in 32.1%, and syncope in 14.8%. In the remaining P (25.8%), ICD was implanted due to syncopal VT (21.2%) or ventricular fibrillation (VF)/aborted SCD (4.6%). Subcutaneous ICD was used in 10.6% of the cases. During a FU of 7.0±5.5 years, ICD detected VA events in 38.7% (NSVT - 25.8%, VT - 6.5%, VF - 4.8%, arrhythmic storm - 1.6%), with a mean time since ICD implantation to the first VA of 4.7±4.3 years. One out of five patients had >1 VA event. Regarding ICD therapies: 11.7% received anti-tachycardia pacing, 16.1% had appropriate shocks, and 7.6% received inappropriate shocks (sinus tachycardia - 1, atrial fibrillation – 4). Mean time to the first VA was shorter in primary prevention implantation (<em>p=</em>0.05). There were no statistically significant differences between primary and secondary prevention groups regarding the type of VA, number of delivered ATP or shocks, and all-cause mortality (15,2%).</p> <p><strong>Conclusion: </strong>Most P had ICD for primary prevention, with a 4.0% annual appropriate therapy rate, and a low incidence of innapropriate shocks. There was a near-equal occurrence of VA, appropriate therapy and mortality in both primary and secondary prevention groups.</p>
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