THE RELATION BETWEEN APICAL HYPERTROPHIC CARDIOMYOPATHY AND SUDDEN CARDIAC DEATH: BENIGN INDEED?

초록

Background Apical hypertrophic cardiomyopathy (HCM) is considered to have a benign prognosis in terms of cardiovascular mortality until now. Prevalence of sudden cardiac death and current status of implantable cardioverter-defibrillator (ICD) implantation in patients with apical HCM remain to be elucidated. Methods Between July 2001 and May 2021, 96 HCM patients who had undergone ICD implantation from three tertiary hospitals were reviewed. We evaluated the prevalence of apical HCM and indication for ICD implantation. Results Fifteen patients (15.6%) were apical HCM, and 81 patients (84.4%) were non-apical type including septal type (n = 56) and diffuse type (n = 25), respectively. Sixty-five patients (67.7%) received ICD implantation for the primary prevention and 31 patients (32.3%) received for the secondary prevention. Among apical HCM, six patients (40.0%) presented with aborted sudden cardiac death or documented VF, therefore received ICD implantation for the secondary prevention. Conclusion Clinical outcomes in patients with apical HCM are not always as benign as previously thought. ICD implantation should be considered in high-risk patients with apical HCM as the same manner with the septal or diffuse type of HCM according to the guideline recommendations.