Hypertrophic cardiomyopathy arrhythmogenesis
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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Patients with hypertrophic cardiomyopathy are at risk of arrhythmias and sudden death. abnormal filling of the left atrium may result in the picture dilation in predispose the patient to atrial fibrillation. the presence of myocardial disarray and myocardial ischemia (due to microvascular dysfunction and they reduce cardiac output) may predispose the patient to ventricular tachycardia, ventricular fibrillation, and sudden death.
Atrial Arrhythmias=
Ventricular Arrhythmias
HCM also causes disruptions of the electrical functions of the heart and can be associated with sudden cardiac death.
Primary arrhythmias, the presence of scar or fibrosis, hemodynamic instability with diminished stroke volume, and/or ischemia have been implicated in the etiology of sudden cardiac death in HCM.
It must be emphasized that atrial arrhythmias (which are commonly detected on ambulatory monitoring) can lead to ischemia and hemodynamic compromise leading to sudden death in these patients as well.
Assessment of autonomic function in patients with HCM often reveals abnormal responses of heart rate and blood pressure to exercise in two-thirds, which was associated with a more malignant clinical course, suggesting that autonomic imbalance may also be important in the genesis of sudden cardiac death in these patients.