Circulation, Vol 59, 866-875, Copyright © 1979 by American Heart Association
DD Savage, SF Seides, BJ Maron, DJ Myers and SE Epstein
Many patients with hypertrophic cardiomyopathy die suddenly and
unexpectedly, a significant number perhaps due to arrhythmia. Of 100
patients initially evaluated for signs or symptoms suggestive of heart
disease or a family history of hypertrophic cardiomyopathy, 51 were
selected solely because they met the echocardiographic criteria for the
disease, and 49 patients were selected primarily because they had: 1)
normal sinus rhythm despite left atrial enlargement, 2) a history of
syncope, 3) a family history of premature death, or 4) a history of
paroxysmal atrial fibrillation. All 100 patients were studied by 24- hour
ambulatory electrocardiographic monitoring and 74 of them also underwent
treadmill exercise testing. More than 50% of patients in repetitive
ventricular premature depolarizations, including 19% who had ventricular
tachycardia. Monitoring was superior to exercise testing for exposing these
arrhythmias. Two patients experienced cardiac arrest within 2 months of
monitoring; in each, monitoring had revealed ventricular tachycardia. Two
patients with paroxysms of supraventricular tachycardia during monitoring
developed fixed atrial fibrillation within 1 year. These preliminary
observations suggest that monitoring may help identify patients at
increased risk for significant arrhythmic events.
ARTICLES
Prevalence of arrhythmias during 24-hour electrocardiographic monitoring and exercise testing in patients with obstructive and nonobstructive hypertrophic cardiomyopathy
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