Login
Search
Search
0 Dates
2026
2025
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
CPC 2025
CPC 2026
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
ICD Decisions in Hypertrophic Cardiomyopathy: Who Truly Benefits?
Session:
Sessão de Posters 48 - Risco arrítmico, tomada de decisão e desfechos nas miocardiopatias
Speaker:
João Mendes Cravo
Congress:
CPC 2026
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.4 Myocardial Disease – Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
João Cravo; Marta Vilela; Catarina Gregório; Beatriz Garcia; Oana Moldovan; Hugo Madeira; Fausto Pinto; Dulce Brito
Abstract
<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction</strong></span></span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">:</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Sudden cardiac death (SCD) remains a major challenge in hypertrophic cardiomyopathy (HCM) management. Although the ESC HCM-Risk-SCD score aids risk stratification and implantable cardiac-defibrillator (ICD) decision-making, uncertainty persists for intermediate risk patients. This raises concerns regarding possible over-implantation and device-related complications. Accurately identifying which patients will benefit from appropriate ICD therapies remains an unmet clinical need.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Aim:</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To identify clinical predictors of appropriate ICD therapies in HCM patients undergoing primary-prevention ICD implantation.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods:</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Single-centre observational study HCM patients with primary-prevention ICD between 2018 and 2024. Appropriate ICD therapy was defined as ATP/Shock for sustained ventricular arrhythmias. Patients were compared according to appropriate therapies occurence. Event-free survival was analysed using Kaplan–Meier methods, with time to first appropriate ICD intervention as the primary endpoint.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results:</strong></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">From a cohort of 156 HCM patients, 34 underwent primary-prevention ICD implantation and were included (mean age 54±4 years, 50% male). Among these patients, next generation sequencing method genetic testing identified </span></span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><em>MYBPC3</em></span></span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"> mutations in 7 (21%) and MYH7 mutations in 4 (12%). 15 (44%) had no pathogenic/likely pathogenic variants</span></span></span><span style="font-size:10.5pt"><span style="font-family:Calibri,sans-serif"><span style="color:#444746">. </span></span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">12% carried more than one sarcomeric mutation. A family history of SCD was present in 30%. At baseline, 9 (27%) were classified as high risk and 13 (38%) as intermediate according to the ESC HCM-Risk-SCD score.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Over a mean follow-up of 4±0.6 years, 9 (26%) received at least one appropriate ICD therapy. In univariable analysis, these patients had higher HCM-Risk-SCD scores at implantation (6%±1 vs 4%±0.3; p=0.043) and larger left atrial diameter (62 [55–67] vs 42 [38–48] mm; p=0.050). No significant differences were found for age, sarcomeric mutation status, maximal LV wall thickness or LVOT gradient.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">In multivariable logistic regression, prior syncope was the only independent predictor of appropriate ICD therapy (OR 17.2, 95% CI 1.63–181.1; p=0.018), independent of age and maximal LV wall thickness. Appropriate ICD therapy was also associated with cardiovascular hospitalization (OR 7.24, 95% CI 1.25–41.8; p=0.027). Kaplan–Meier analysis showed a median time to first therapy of 5.0 years (95% CI 4.1–5.9), w</span></span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">ith an estimated mean event-free survival of 7.7 years (95% CI 5.1–10.3). Only 1 patient had inappropriate ICD therapy due to atrial fibrillation.</span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong></span></span></span><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">:</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">In this cohort, prior syncope was the most informative marker for subsequent appropriate ICD therapies, while conventional risk factors showed limited discriminatory value. These findings suggest that current stratification may not fully identify those most likely to benefit, highlighting the need for refinement in primary-prevention ICD selection.</span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site