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Hypertrophic cardiomyopathy with massive hypertrophy, amiodarone treatment and high defibrillation threshold at cardioverter–defibrillator implant

2002; Elsevier BV; Volume: 83; Issue: 2 Linguagem: Inglês

10.1016/s0167-5273(02)00036-0

1874-1754

Giuseppe Boriani, Claudio Rapezzi, Mauro Biffi, Angelo Branzi,

Viral Infections and Immunology Research

Spirito et al. [ [1] Spirito P. Bellone P. Harris K.M. Bernabo' P. Bruzzi P. Maron B. Magnitude of left ventricular hypertrophy and risk of sudden death in hypertrophic cardiomyopathy. N Engl J Med. 2000; 342: 1778-1785 Crossref PubMed Scopus (859) Google Scholar ] recently reported on the high risk of sudden cardiac death in patients affected by hypertrophic cardiomyopathy presenting a pattern of massive left ventricular hypertrophy at cross-sectional echocardiogram (intraventricular septum thickness of 30 mm or more). These findings, together with the data reported by Maron et al. [ [2] Maron B. Shen K.W. Link M.S. et al. Efficacy of implantable cardioverter–defibrillators for the prevention of sudden death in patients with hypertrophic cardiomyopathy. N Engl J Med. 2000; 342: 365-373 Crossref PubMed Scopus (857) Google Scholar ] on the outcome of patients with hypertrophic cardiomyopathy following implant of a cardioverter–defibrillator, both for secondary and primary prevention of sudden cardiac death, strongly suggest the implant of these devices in appropriately selected patients. These observations will probably lead to an increasing number of cardioverter–defibrillator implants and in this case some considerations on the potential problems that may occur at implant appear to be clinically useful. The overall experience on cardioverter–defibrillator implants, mainly based on coronary artery disease patients, has shown that relatively high defibrillation thresholds may be found in some patients, especially in those under chronic amiodarone treatment [ 3 Fogoros R.N. Amiodarone-induced refractoriness to cardioversion. Ann Intern Med. 1984; 100: 699-700 Crossref PubMed Scopus (82) Google Scholar , 4 Boriani G. Biffi M. Frabetti L. Maraschi M. Branzi A. High defibrillation threshold at cardioverter defibrillator implantation under amiodarone treatment: favorable effects of dl-sotalol. Heart Lung. 2000; 29: 412-416 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , 5 Pelosi F. Oral H. Kim M.H. et al. Effect of chronic amiodarone therapy on defibrillation energy requirements in humans. J Cardiovasc Electrophysiol. 2000; 11: 736-740 Crossref PubMed Scopus (54) Google Scholar , 6 Dorian P. Amiodarone and defibrillation thresholds: a clinical conundrum. J Cardiovasc Electrophysiol. 2000; 11: 741-743 Crossref PubMed Scopus (14) Google Scholar ].