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Electrophysiologic evaluation of patients with hypertrophic cardiomyopathy
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
Insights
This study investigated arrhythmias in hypertrophic obstructive cardiomyopathy (HOCM) patients. Electrophysiologic evaluation revealed various abnormalities, including inducible ventricular tachycardia, highlighting the need for further research into their clinical significance.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) is a complex cardiac condition.
- Arrhythmias are a known complication, but their spectrum and clinical correlates in HOCM require further elucidation.
Purpose of the Study:
- To detect the spectrum of arrhythmias in HOCM patients.
- To identify potential clinical correlates of these arrhythmias.
Main Methods:
- Detailed electrophysiologic evaluation was performed on ten consecutive HOCM patients.
- Twenty-four-hour ambulatory monitoring was utilized to assess cardiac rhythm.
Main Results:
- Ambulatory monitoring detected isolated ventricular ectopics, couplets, and atrioventricular dissociation in some patients.
- Electrophysiologic studies revealed inducible nonsustained ventricular tachycardia and supraventricular tachycardia in a subset of patients.
- Accessory atrioventricular connections and conduction abnormalities were also observed.
Conclusions:
- A variety of electrophysiologic abnormalities were demonstrated in patients with hypertrophic cardiomyopathy.
- Inducible arrhythmias were found even in some patients without syncope.
- Further studies are warranted to determine the clinical significance of these arrhythmias in HOCM.
Abstract:
Ten consecutive patients with hypertrophic obstructive cardiomyopathy proven by echocardiography were subjected to detailed electrophysiologic evaluation and 24-hour ambulatory monitoring to detect the spectrum of arrhythmias and to identify their clinical correlates, if any. Two patients presented with syncope and the others with varying grades of dyspnea and angina. Ambulatory monitoring revealed isolated ventricular ectopics in five patients including couplets in two cases and runs of atrioventricular dissociation in two patients. Four patients had a normal study. Electrophysiologic evaluation demonstrated inducible nonsustained ventricular tachycardia in two patients (one with syncope and the other without syncope), short runs of supraventricular tachycardia in one (with a history of syncope), an accessory atrioventricular connexion in one patient (without any inducible arrhythmia), short atrio-His interval with minimal prolongation on incremental atrial pacing in three patients and ventriculoatrial conduction in two patients. A variety of electrophysiologic abnormalities was demonstrated in patients with hypertrophic cardiomyopathy. In two patients with a history of syncope only a nonsustained tachycardia was inducible. Further studies are warranted to find out the significance of these arrhythmias.