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Ventricular activation time as a marker for complex ventricular arrhythmias, sudden cardiac death and ICD implantation in hypertrophic cardiomyopathy

Title: Ventricular activation time as a marker for complex ventricular arrhythmias, sudden cardiac death and ICD implantation in hypertrophic cardiomyopathy
Authors: Fragkiadakis, K; Marketou, M; Parthenakis, F; Kochiadakis, G
Source: European Heart Journal ; volume 43, issue Supplement_2 ; ISSN 0195-668X 1522-9645
Publisher Information: Oxford University Press (OUP)
Publication Year: 2022
Description: Background Identification of patients with hypertrophic cardiomyopathy (HCM) who are at high risk of sudden cardiac death (SCD) is essential, as life-threatening ventricular arrhythmias (VAs) can be effectively prevented with an implantable cardioverter defibrillator (ICD). Risk stratification using HCM Risk-SCD score is recommended in the 2014 ESC guidelines for the management of patients with HCM. However, the role of electrocardiogram (ECG) in risk stratification is less well established. Purpose We investigated the association between the ventricular activation time (VAT), an ECG marker of the duration of ventricular depolarization, with the HCM Risk-SCD score, the presence of complex VAs, the implantation of an ICD and ICD-therapy for VAs. Methods Patients with a history of HCM, documented by echocardiography, were studied. The 12-lead ECG and echocardiography were performed on the same day. On ECG, we evaluated the VAT in milliseconds, between the onset of the QRS complex to the peak of R wave on V5 or V6 precordial ECG leads. A careful personal and family history for unexplained syncope and SCD was obtained, respectively. The presence of non-sustained ventricular tachycardia (NSVT) and ICD therapy were assessed either with 48h ECG recording or ICD interrogation. HCM Risk-SCD score was calculated by the corresponding ESC online calculator. Statistical analysis was performed using the SPSS software. Results Thirty-three patients with HCM were included (mean age 51±12 years, 78.8% male). According to the HCM Risk-SCD score, HCM patients were divided into three groups: low-risk (
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurheartj/ehac544.1722
Availability: https://doi.org/10.1093/eurheartj/ehac544.1722; https://academic.oup.com/eurheartj/article-pdf/43/Supplement_2/ehac544.1722/46367539/ehac544.1722.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.255213B6
Database: BASE