Background: Primary prevention of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy
(HCM) is a worldwide problem with under- or overuse of implantable cardioverter-defibrillator
(ICD). European Society of Cardiology (ESC) recommends the use of HCM Risk-SCD model
before the implantation of ICD as primary prevention in the current published in 2014.
The purpose go this study was to examine the appropriateness of HCM Risk-SCD model
in Japanese patients with HCM. Methods: Consecutive patients with HCM implanted ICD for secondary prevention in our hospital
between 2012 and 2016 were analyzed based on clinical records retrospectively. Results: Ten patients with HCM (1 HOCM, 6 HNCM, 2 apical HCM, 1 dilated HCM; aged 19 to 79
years; 8 males and 2 females) were implanted with ICD for secondary prevention after
aborted SCD. The 5-year risk of SCD estimated in these patients assuming without aborted
SCD using the HCM Risk-SCD model was 1.85 ± 0.84 (SD) % (ranged between 0.85 and 3.07%),
none of which was above 4% that is the cutoff point which ICD implantation may be
considered as primary prevention. Conclusions: Since none of patients implanted with ICD after aborted SCD was a candidate for ICD
implantation as primary prevention, the HCM Risk-SCD model may not be applicable to
Japanese patients due to its low negative predictive value.
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