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Sudden cardiac arrest in patients with hypertrophic cardiomyopathy: Are there electrocardiographic predictors?

Jashan Gill1, Rezwan Munshi1, Jobin Varghese1

  • 1Department of Cardiology, MercyOne North Iowa Medical Center, IA, United States of America.

Journal of Electrocardiology
|March 13, 2025
PubMed

Insights

Electrocardiographic abnormalities like AV block, BBB, AF, AFL, SVT, and PVCs increase cardiac arrest risk in hypertrophic cardiomyopathy (HCM) patients. These findings may aid in primary prevention strategies for sudden cardiac death (SCD).

Area of Science:

  • Cardiology
  • Electrophysiology
  • Public Health

Background:

  • Hypertrophic cardiomyopathy (HCM) is a known risk factor for sudden cardiac arrest (CA).
  • Established risk factors guide implantable cardioverter-defibrillator (ICD) use for primary prevention.
  • The association between specific electrocardiographic (ECG) predictors and CA risk in HCM remains unclear.

Purpose of the Study:

  • To investigate the risk of CA in patients with HCM.
  • To determine if specific ECG arrhythmias and conduction disorders are associated with CA in HCM patients.

Main Methods:

  • Analysis of the National Inpatient Sample (NIS) database from Q4 2015 to 2020.
  • Inclusion of adult HCM hospitalizations identified by ICD-10 codes, excluding syncope or prior ICD.
  • Comparison of CA odds in patients with atrioventricular (AV) block, bundle branch block (BBB), atrial fibrillation (AF), atrial flutter (AFL), supraventricular tachycardia (SVT), and premature ventricular contractions (PVCs), with adjusted regression models.

Main Results:

  • Out of 251,450 HCM hospitalizations, 5% were associated with CA.
  • HCM patients with CA were younger and had fewer comorbidities.
  • The presence of AV block, BBB, AF, AFL, SVT, or PVCs was associated with increased odds of CA.

Conclusions:

  • AV block, BBB, AF, AFL, SVT, and PVCs are associated with increased odds of CA in HCM patients.
  • These ECG findings may serve as independent predictors for primary sudden cardiac death (SCD) prevention.
  • Further prospective research is needed to validate these predictors for guiding primary SCD prevention strategies.
Abstract

Keywords:
Cardiac arrestElectrocardiogramHypertrophic cardiomyopathySudden cardiac death

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