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Cardiac implantable electrical devices in patients with hypertrophic cardiomyopathy: single center implant data

Cinzia Valzania1, Fredrik Gadler2,3, Giuseppe Boriani4

  • 1Department of Cardiology, S.Orsola Hospital, University of Bologna, Bologna, Italy.

Scandinavian Cardiovascular Journal : SCJ
|February 15, 2020
PubMed

Insights

This study analyzed cardiac implantable electrical device (CIED) first implants in hypertrophic cardiomyopathy (HCM) patients. Implantable cardioverter-defibrillators (ICDs) were more common than pacemakers, with distinct patient profiles for each device type.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a significant condition requiring cardiac rhythm management.
  • Cardiac implantable electrical devices (CIEDs) play a crucial role in managing arrhythmias and heart failure in HCM patients.
  • Understanding implantation trends and patient characteristics is vital for optimizing care.

Purpose of the Study:

  • To investigate the trends and characteristics of first-time CIED implants in patients diagnosed with HCM.
  • To compare the demographic and clinical profiles of HCM patients receiving pacemakers versus implantable cardioverter-defibrillators (ICDs).
  • To analyze the utilization of different CIED types, including pacemakers, ICDs, and cardiac resynchronization therapy (CRT) devices.

Main Methods:

  • Retrospective analysis of clinical and technical data from a Swedish tertiary university hospital (Karolinska University Hospital) between 2005 and 2016.
  • Data extracted from the Swedish Pacemaker and ICD Registry, supplemented with echocardiographic data.
  • Inclusion criteria focused on patients with hypertrophic cardiomyopathy undergoing first-time CIED implantation.

Main Results:

  • A total of 70 first pacemaker implants and 99 first ICD implants were performed in HCM patients.
  • ICDs constituted 59% of all CIED first implants in this cohort.
  • Pacemaker recipients were older (mean age 71 years) and evenly distributed by gender, while ICD recipients were younger (mean age 53 years) and predominantly male (70%).
  • A significant proportion of ICDs (66%) were implanted for primary prevention.
  • Obstructive HCM was noted in 47% of pacemaker patients and 25% of ICD patients with available pre-implant echocardiograms.

Conclusions:

  • CIED first implants in HCM patients show distinct epidemiological and clinical profiles depending on the device type (pacemaker vs. ICD).
  • ICDs were the predominant CIED implanted in this HCM cohort.
  • This study highlights the importance of tailored device selection and management strategies for HCM patients requiring CIEDs.

Keywords:
Cardiac resynchronization therapycardiomyopathymedical devicespacingregistry

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