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Implantable cardioverter-defibrillator therapy for primary prevention of sudden death after alcohol septal ablation of hypertrophic cardiomyopathy
JACC - Journal of the American College of Cardiology, 11/13/08

Cuoco FA et al. – The annual rate of appropriate implantable cardioverter-defibrillator (ICD) discharges after alcohol septal ablation (ASA) is low and less than reported previously for primary prevention of sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). This finding suggests that ASA is not proarrhythmic. Traditional SCD risk factors did not predict ICD shocks in this cohort.

• Study of the effects of ASA on ventricular arrhythmias among pts with obstructive HCM as measured by appropriate ICD discharges
• Prospective study included 123 consecutive pts with obstructive HCM who had ASA and ICD implantion for primary prevention of SCD
• ICD implantation based on commonly accepted risk factors for SCD in the HCM population
• Review of data from ICD interrogations during routine follow-up

• Over mean follow-up of 2.9 yrs, 9 appropriate ICD shocks recorded
• Mean of 1.5 +/- 0.9 risk factors for SCD
• Estimated annual event rate: 2.8% over 3-yr follow-up
• No significant differences in risk factor incidence between pts who did and did not receive appropriate shock

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