title: Implantable Cardioverter-defibrillator Therapy for Hypertrophic Cardiomyopathy: Usefulness in Primary and Secondary Prevention.
abstract: OBJECTIVE
  Hypertrophic cardiomyopathy is a frequent cause of sudden death. Clinical practice guidelines indicate defibrillator implantation for primary prevention in patients with 1 or more risk factors and for secondary prevention in patients with a history of aborted sudden death or sustained ventricular arrhythmias. The aim of the present study was to analyze the follow-up of patients who received an implantable defibrillator following the current guidelines in nonreferral centers for this disease.
  
  
  METHODS
  This retrospective observational study included all patients who underwent defibrillator implantation between January 1996 and December 2012 in 3 centers in the province of Barcelona.
  
  
  RESULTS
  The study included 69 patients (mean age [standard deviation], 44.8 [17] years; 79.3% men), 48 in primary prevention and 21 in secondary prevention. The mean number of risk factors per patient was 1.8 in the primary prevention group and 0.5 in the secondary prevention group (P=.029). The median follow-up duration was 40.5 months. The appropriate therapy rate was 32.7/100 patient-years in secondary prevention and 1.7/100 patient-years in primary prevention (P<.001). Overall mortality was 10.1%. Implant-related complications were experienced by 8.7% of patients, and 13% had inappropriate defibrillator discharges.
  
  
  CONCLUSIONS
  In patients with a defibrillator for primary prevention, the appropriate therapy rate is extremely low, indicating the low predictive power of the current risk stratification criteria.
authors.affiliation: Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. Electronic address: axelsarrias@gmail.com.
authors.forename: Axel
authors.initials: A
authors.lastname: Sarrias
authors.affiliation: Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Galve
authors.affiliation: Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Sabaté
authors.affiliation: Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Àngel
authors.initials: À
authors.lastname: Moya
authors.affiliation: Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Anguera
authors.affiliation: Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain.
authors.forename: Elaine
authors.initials: E
authors.lastname: Núñez
authors.affiliation: Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Roger
authors.initials: R
authors.lastname: Villuendas
authors.affiliation: Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Alcalde
authors.affiliation: Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: García-Dorado
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002312:Cardiomyopathy, Hypertrophic / Q000517:prevention & control*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D000638:Amiodarone
keywords: Cardiomyopathy; Defibrillator; Desfibrilador; Factores de riesgo; Hipertrofia; Hypertrophy; Miocardiopatía; Muerte súbita; Risk factors; Sudden death