2017, Number 3
Risk stratification in sudden death due to hypertrophic cardiomyopathy
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Language: Spanish
References: 0
Page: 218-221
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To the Editor:
In the last two years, important works on hypertrophic
cardiomyopathy (HCM) have been published.
From the clinical point of view, perhaps, the
most important has been the publication of the Diagnosis
and Treatment Guidelines of the ESC (European
Society of Cardiology)1. In this document, one
of the novelest aspects has been the presentation of
a new risk index of sudden death.
The classic risk stratification based its recommendation
for the implementation of an implantable
cardioverter-defibrillator (ICD) in the presence of
one or two risk factors of sudden death, from a list of
clinical markers including: presence of severe hypertrophy
(> 30 mm), severe obstruction (> 90
mmHg), non-sustained ventricular tachycardia
(NSVT), history of unexplained syncope, family history
of sudden death at young age, or abnormally
flat blood pressure response in the stress test. The
American guidelines consider, even today, that the
high-risk patient is one who has at least one of the
aspects of the list, while in the previous European
guidelines it was considered that the presence of
two of these was enough to implement an ICD.