Heart failure & cardiomyopathies
Predictors of sudden cardiac death in postmyectomy hypertrophic cardiomyopathy with obstruction
Authors' conclusion
Preoperative LGE extent was associated with increased SCD in the postmyectomy HCM with obstruction population. This finding supports active prevention of SCD with implantable cardioverter-defibrillators in patients with evident preoperative LGE and close monitoring of the progression of LGE.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) with obstruction indicated for surgical septal myectomy and with complete preoperative contrast-enhanced cardiac magnetic resonance data, April 2008 to December 2020final study cohort
- Participants
- 1,389 patients
- Outcome
- Composite of:
- SCD
- Its equivalents after surgical septal myectomy
- Follow-up
- Median 3.29 years (interquartile range, 2.06-5.36 years)
Main finding
As reported in the abstract
Patients meeting the primary endpoint
16 patients
1.8%
Sudden cardiac death (SCD)
11 patients
0.83%
Aborted SCD
5 patients
0.38%
Further findings
| Outcome | Subdistribution hazard ratio (95% CI) | P value | |
|---|---|---|---|
| Preoperative LGE extent as predictor of SCD after surgical septal myectomy (multivariable competing risk regression)Per-unit estimate; associated with SCD · multivariable competing risk regression | 1.06 (1.01–1.12) | P = 0.027 | |
| 0.512Subdistribution hazard ratio (log scale) |
Baseline characteristics
- Median age
- 48 years (interquartile range, 37.3-57.0 years)
- Women
- 540 (38.9%)
All-cause mortality
- All-cause mortality
- 40 patients (3.03%)
Survival free of SCD · 5 years
- Survival free of SCD
- 98.5% (95% confidence interval, 97.6-99.5)
Original publication
Predictors of sudden cardiac death in postmyectomy hypertrophic cardiomyopathy with obstruction. Heart Rhythm. Published 12 May 2025. doi:10.
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