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Use of Disopyramide in Obstructive Hypertrophic Cardiomyopathy: A European Insight

Philippe Charron1, Faizel Osman2,3, Jean-Noel Trochu4

  • 1Department of Cardiology & Department of Genetics, Hôpital Universitaire Pitié-Salpêtrière, IHU-ICAN, INSERM 1166, AP-HP, Sorbonne Université, 75013 Paris, France.

Journal of Clinical Medicine
|June 12, 2026
PubMed

Insights

Disopyramide use is very low in obstructive hypertrophic cardiomyopathy (HCM) patients across England and France, with minimal uptake in Germany. Barriers like cost and availability may limit its use, potentially increasing adoption of alternative therapies.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) guidelines recommend disopyramide as an add-on therapy for persistent symptoms.
  • Real-world data on disopyramide use beyond single centers are scarce.
  • This study evaluated disopyramide utilization in obstructive HCM before cardiac myosin inhibitors became available.

Purpose of the Study:

  • To quantify the use of disopyramide in obstructive HCM patients in England, France, and Germany.
  • To identify potential barriers to disopyramide prescription in routine clinical practice.

Main Methods:

  • Retrospective analysis of national healthcare databases from England, France, and Germany (2010-2019).
  • Inclusion criteria: adults (18+) diagnosed with obstructive HCM or HCM requiring septal reduction therapy.
  • Disopyramide usage defined as at least one prescription per patient annually.

Main Results:

  • Identified 3730 (England), 6823 (France), and 1141 (Germany) obstructive HCM patients.
  • Annual disopyramide use was 4.7%-5.6% in England and 1.7%-2.6% in France.
  • No reimbursed disopyramide use was recorded in Germany during the study period.

Conclusions:

  • Disopyramide use in obstructive HCM is notably low across the studied European countries.
  • Potential contributing factors include treatment-related issues, drug availability, and lack of reimbursement.
  • These limitations may encourage the adoption of alternative guideline-recommended therapies for obstructive HCM.

Keywords:
disopyramideguideline-directed treatmenthypertrophic cardiomyopathyleft ventricular outflow tract obstructionobstructiontherapy

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