Photo Credit: Alkov

The following is a summary of “Predictors of Arrhythmic Events in Hypertrophic Cardiomyopathy Patients with an Implantable Cardioverter-Defibrillator: A Systematic Review and Meta-Analysis,” published in the April 2025 issue of European Heart Journal – Quality of Care and Clinical Outcomes by Chiotis et al. 

Hypertrophic cardiomyopathy (HCM) had been recognized as a common inherited heart condition and a major cause of sudden cardiac death (SCD), though risk stratification for implantable cardioverter-defibrillators (ICDs) remained difficult.  

Researchers conducted a retrospective study to assess the predictive performance of conventional risk factors for arrhythmic events in adults with Hypertrophic cardiomyopathy (HCM) who had ICDs.  

They searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Clinical Trials from the inception through November 2024. The search included studies that reported hazard ratios (HRs) for electrocardiographic, clinical, and imaging predictors of arrhythmic events in individuals with HCM who had ICDs, and the pooled HRs were estimated by a random-effects model.  

The results showed that 12 studies involving 3,297 individuals with HCM and ICDs were included, with 91% in primary prevention and 9% in secondary prevention. The mean age was 50 years, and the annual arrhythmic event rate was 5% (95% CI: 4–7%) over an average follow-up of 4 years. The substantial predictors of arrhythmic events included non-sustained ventricular tachycardia (NSVT) (HR: 2.19, 95% CI: 1.62–2.98), left ventricular ejection fraction (LVEF) < 50% (HR: 1.91, 95% CI: 1.27–2.89), intraventricular pressure gradient (IVPG) > 30 mmHg (HR: 1.92, 95% CI: 1.03–3.56), and secondary prevention indication (HR: 2.18, 95% CI: 1.39–3.41), the sensitivity analysis confirmed NSVT and LVEF < 50% as consistently significant predictors in the primary prevention subgroup, while other traditional risk factors had limited predictive value.  

Investigators concluded that while specific markers remained powerful predictors of arrhythmic events in patients with HCM along with ICDs, and the other traditional risk factors may have lacked predictive utility. 

Source: academic.oup.com/ehjqcco/advance-article-abstract/doi/10.1093/ehjqcco/qcaf021/8114743