While competitive sports used to be frowned upon in the HCM literature, there is now some evidence that a patient’s risk from exercise is low when they have been implanted with an implantable cardioverter defibrillator (ICD). This feature from Medpage Today gives an overview of contemporary thinking about exercise in HCM patients.
Comprehensive risk assessment, combined with shared decision making around the decision to participate in sports, seems to be the way of the future. This is more fully discussed in the most recent ACC/AHA Guidelines.
However, ICDs should only be implanted if the patient is clearly at risk of sudden cardiac arrest; they should not be implanted solely for the purpose of allowing a low risk patient to participate in sports.
HCM specialists at Tufts Medical Center and Toronto General Hospital have devised a formula which they hope will help predict which HCM patients may go on to develop atrial fibrillation (“AFib”) over time. This tool can assist doctors in determining which patients are at highest risk so that these patients can be closely monitored and treated appropriately. AFib can be extremely dangerous for HCM patients since it can precipitate a stroke if not appropriately treated.
Because existing tools to predict atrial fibrillation have not proven to be accurate for HCM patients, the researchers studied 1900 HCM patients with the goal of devising a new tool to help HCM patients and their physicians learn their personal risk for AFib over a 2 and 5 year period.
Continue reading “Can This Formula Predict AFib in HCM Patients?”
A recent study published in the European Journal of Preventative Cardiology found that a 12-lead electrocardiogram (EKG) was not useful as a screening tool to determine which children were at increased risk of sudden death and therefore, a candidate to receive an implantable defibrillator.
The full article can be found here.
If you are looking for a good survey of current practices in the treatment of HCM, a recent article published in the journal Structural Heart by Dr. Ahmad Masri and the team at Oregon Health and Sciences University (OHSU) provides an informative overview of thirty controversies and considerations in the treatment of HCM. This article explains in some detail how the doctors at this HCM Center approach these situations.
Continue reading “HCM Treatment: The View from OHSU”
The highly anticipated 2020 American Heart Association/American College of Cardiology Guidelines for the Diagnosis and Treatment of Patients with Hypertrophic Cardiomyopathy have been released.
This document, drafted with reference to published HCM literature, and with input from a committee of HCM experts with broad expertise, updates the prior version published in 2011. It contains clinical practice guidelines for the broad spectrum of issues which may confront medical professionals as they approach the diagnosis and treatment of patients and families affected by hypertrophic cardiomyopathy.
Continue reading “2020 AHA/ACC HCM Diagnosis & Treatment Guidelines Released – Updated With New Links”
According to a recent paper published in Circulation, children’s risk for sudden death should be evaluated using different risk factors than those used for adults.
Two main differences seen between factors influencing the risk of sudden death of children and adults were that:
- for children, family history of sudden death was not a risk factor;
- a left ventricular outflow tract gradient in a child suggested a lower risk of sudden death.
The authors of this study propose that the risk assessment factors highlighted in this study (and not the various risk assessment tools that have been developed for adults) should be used by clinicians to evaluate the need for implantable defibrillators in children.