Sudden Cardiac Death in Patients With Hypertrophic Cardiomyopathy

This literature review is devoted to the problem of studying sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). It covers prevalence of SCD and its structure among young individuals and trained athletes, contains discussion of relation of SCD to sex, age, and hypertrophic response of myocardium to physical exercise. Modern views on arrhythmogenic substrate underlying SCD in HCM as well as pathophysiologic cascade of life-threatening ventricular tachyarrhythmia are presented in detail. Approaches to identification of individuals at high risk of SCD are described and main and supplemental clinical criteria are discussed from the point of view of SCD risk stratification. The review also contains results of large trials assessing the role of implantable cardioverter-defibrillators (ICD) in primary and secondary prevention of SCD in HCM patients, and recommendations on appropriateness of ICD implantation taking into account efficiency of these devices and rate of complications.