[SCD-FORUM] 89S Prophylactic ICD in nonobstructive asymmetrical Idiopathic Hypertrophic Cardiomyopathy? Dr. Landaeta

[SCD Symposium]

Dear attendants to this great symposium on the Internet,
I wish to pose the case of a 50-year-old female patient with first  
episode (3 years ago) of paroxysmal atrial fibrillation with rapid  
ventricular response (170 b/min), which was accompanied by precordial  
oppression and prolonged presyncope. She has been receiving treatment  
with verapamil, atenolol, separately or combined, inconstantly. In a  
recurrent way, she presents clinics of “palpitations” related to  
paroxysmal AF in several ECG recordings, now with preserved  
ventricular response. The resting ECG shows a sinus rhythm pattern,  
and a normal one. TT echocardiogram shows baseline Septum Hypertrophy  
of 15 mm (asymmetrical) without Intraventricular or transvalvular  
gradients; the left atrium slightly dilated, the LVEF is preserved.  
The functional class is I according to the NYHA. She denies family  
history of “sudden” death due to any cause. I am thinking of starting  
treatment with amiodarone to prevent recurrences of AF. However, what  
role may the indication of an ICD have to prevent SCD on this  
patient? Which would be the other risk stratification tests for SD  
applicable in this situation?

Thank you very much,
Dr. César Landaeta T.
Cardiologo Electrofisiólogo
Venezuela

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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