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Syncope in hypertrophic cardiomyopathy (part II): An expert consensus statement on the diagnosis and management

Michele Brignole1, Franco Cecchi1, Aris Anastasakis2

  • 1IRCCS Istituto Auxologico Italiano, Dept of Cardiology, Hospital S. Luca, Milan, Italy.

International Journal of Cardiology
|October 29, 2022
PubMed

Insights

Syncope in hypertrophic cardiomyopathy (HCM) is critical for sudden cardiac death risk. This consensus provides guidance for diagnosing and managing unexplained syncope in HCM patients.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Syncopal events are a significant concern in hypertrophic cardiomyopathy (HCM) patients.
  • Syncope is a key factor in risk stratification for sudden cardiac death (SCD) and implantable cardioverter-defibrillator (ICD) implantation.
  • The etiology of syncope in HCM is frequently under-investigated or remains unexplained, with current guidelines lacking a precise definition for unexplained syncope.

Purpose of the Study:

  • To address the gap in understanding and managing syncope in HCM.
  • To provide practical guidance for the diagnosis and management of syncope in HCM patients.
  • To establish a consensus among international experts in syncope and HCM.

Main Methods:

  • An international expert panel convened to discuss syncope in HCM.
  • A consensus document was drafted based on expert opinion and existing literature.
  • The document focuses on practical diagnostic and management strategies.

Main Results:

  • The consensus document offers a framework for evaluating unexplained syncope in HCM.
  • It aims to improve the investigation and management of syncopal episodes in this population.
  • Guidance is provided for risk stratification and therapeutic decisions.

Conclusions:

  • Standardized approaches are needed for syncope evaluation in HCM.
  • Expert consensus can guide clinical practice in managing HCM patients with syncope.
  • Further research may be warranted to elucidate specific mechanisms and optimize treatment.

Keywords:
DiagnosisHypertrophic cardiomyopathyImplantable defibrillatorReflex syncopeRisk stratificationSudden cardiac deathSyncope

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