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Implantable Cardioverter-Defibrillator Therapy in Apical Hypertrophic Cardiomyopathy: Insights From a Multicenter
Yae Min Park1, Jaemin Shim2, Mi Suk Cha1
1Division of Cardiology, Gachon University Gil Medical Center, Incheon, Korea.
Korean Circulation Journal
|May 28, 2026
Summary
Sudden cardiac death (SCD) risk markers are present in apical hypertrophic cardiomyopathy (HCM) patients receiving implantable cardioverter-defibrillators (ICDs). Apical HCM patients with ICDs showed similar long-term outcomes to non-apical HCM patients.
Area of Science:
- Cardiology
- Electrophysiology
- Genetics
Background:
- Sudden cardiac death (SCD) risk stratification in apical hypertrophic cardiomyopathy (HCM) requires further definition.
- Established SCD risk markers and implantable cardioverter-defibrillator (ICD) outcomes are not well-characterized in apical HCM.
Purpose of the Study:
- To evaluate SCD risk markers in apical HCM patients with aborted cardiac arrest (ACA) or ventricular fibrillation (VF).
- To compare long-term ICD therapy outcomes between apical and non-apical HCM patients.
Main Methods:
- Analysis of 96 HCM patients who underwent ICD implantation.
- Assessment of 2024 AHA/ACC and 2023 ESC guideline-recommended SCD risk markers in apical HCM patients with ACA/VF.
- Comparison of long-term ICD therapy outcomes between apical and non-apical HCM cohorts.
Main Results:
- Apical HCM patients (15.6%) with ACA/VF (46.7%) presented with at least one SCD risk marker.
- Common risk markers included late gadolinium enhancement, syncope, non-sustained ventricular tachycardia, and left atrial enlargement.
- No significant differences in total or appropriate ICD therapy events were found between apical and non-apical HCM groups over ~6 years.
Conclusions:
- Apical HCM patients receiving ICDs for secondary prevention exhibit significant risk markers and remain at risk for ventricular arrhythmias.
- Risk-guided ICD implantation and diligent long-term follow-up are recommended for high-risk apical HCM patients.
Keywords:
Aborted cardiac arrestApical hypertrophic cardiomyopathyImplantable cardioverter-defibrillatorOutcomesSudden cardiac deathMore Related Videos
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