Risk stratification for sudden cardiac death after septal myectomy

Richard D Rothman; Muhamad A Safiia; Patricia A Lowry; Theofanie Mela; Suhny Abbara; Caitlin O'Callaghan; Eugene J Mark; Gus J Vlahakes; Michael A Fifer

doi:10.1016/j.jccase.2010.12.002

Risk stratification for sudden cardiac death after septal myectomy

J Cardiol Cases. 2011 Jan 13;3(2):e65-e67. doi: 10.1016/j.jccase.2010.12.002. eCollection 2011 Apr.

Authors

Richard D Rothman¹, Muhamad A Safiia¹, Patricia A Lowry¹, Theofanie Mela¹, Suhny Abbara¹, Caitlin O'Callaghan¹, Eugene J Mark¹, Gus J Vlahakes¹, Michael A Fifer¹

Affiliation

¹ Cardiology Division, Department of Medicine, Cardiac Surgical Division, Department of Surgery, and Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Abstract

Background: The importance of risk stratification for sudden cardiac death (SCD) after septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM) has not been emphasized previously.

Methods and results: We report 2 patients with SCD or ventricular tachycardia (VT) after septal myectomy for HOCM in whom risk factors for SCD were identified following surgical myectomy. One received an implantable cardioverter-defibrillator (ICD), which subsequently provided appropriate discharges for VT. The other delayed ICD implantation and suffered SCD.

Conclusion: These cases emphasize the importance of risk stratification for SCD after septal myectomy for HOCM.

Keywords: Cardioverter-defibrillator; HOCM; Heart disease; Hypertrophic cardiomyopathy; Myectomy; Risk factors; Septal reduction therapy.