![]() ![]() All patients had an HCM Risk-SCD score <6%. This was a prospective observational study which included all consecutive adults with HCM who received a Reveal LINQ (Medtronic Inc., Minneapolis, MN, USA) between November 2014 and February 2019. The aim of the present study was to evaluate the incremental value of ICMs compared to a conventional strategy (i.e., Holter monitoring) in adults with HCM and a low or intermediate HCM Risk-SCD score. In the past 5 years, we adopted a strategy to use an ICM in HCM patients at low to intermediate risk of SCD for the detection of subclinical arrhythmias, with a particular emphasis on the detection of VT. Furthermore, HCM patients with documented atrial fibrillation (AF) should receive oral anticoagulation to prevent stroke. For example, the detection of ventricular tachycardia (VT) may have an impact on risk stratification for SCD and the decision to implant an implantable cardioverter-defibrillator (ICD). This higher diagnostic yield may be clinically relevant in this patient population. ![]() ![]() Theoretically, the diagnostic yield for the detection of arrhythmias is higher for an ICM in comparison to intermittent Holter monitoring. The 2014 ESC HCM guidelines recommend the use of ambulatory Holter monitoring to detect atrial and ventricular arrhythmias every 12–24 months or more often in the case of symptoms or left atrial dilatation. However, these recommendations are based on scarce data and there are no comparative data with ambulatory Holter monitoring. Furthermore, an ICM may be considered for HCM patients with frequent unexplained palpitations. The current ESC guidelines recommend that HCM patients with recurrent episodes of unexplained syncope, who are at low risk of sudden cardiac death (SCD), should be considered for an ICM. The exact role of ICMs in patients with hypertrophic cardiomyopathy (HCM) is less clear. Insertable cardiac monitors (ICMs) provide continuous rhythm monitoring and are useful for the detection of infrequent arrhythmias, especially in patients with recurrent unexplained syncope. In contrast, the diagnostic yield of detecting VT seems similar for both groups. Conclusions: In adults with HCM, an ICM will detect more arrhythmic events requiring an intervention than a conventional Holter strategy. Furthermore, the characteristics of VT were similar between groups with regard to the number of beats and rate. The cumulative rate of VT episodes at 30 months was similar between groups (23% vs. Overall, 4 implantable cardioverter-defibrillators were implanted for primary prevention ( n = 2 in each group). De novo atrial fibrillation requiring oral anticoagulation occurred only in the ICM group ( n = 3). Results: The cumulative actionable event rate at 30 months was higher in the ICM group (51 vs. The secondary endpoint was the occurrence of ventricular tachycardia (VT). The primary endpoint was an actionable event which was defined as an arrhythmic event resulting in a change in patient management. The mean HCM Risk-SCD score was 3.41 ± 1.31 and 3.31 ± 1.43 for the ICM and Holter groups, respectively. We retrospectively identified a control group of 25 patients who were matched on age, sex, and HCM Risk-SCD score category. Methods: We studied 50 patients (mean age 52 years, 72% men) with HCM at low or intermediate risk for sudden cardiac death (SCD), of whom 25 patients received an ICM between November 2014 and February 2019. Aims: The aim of the present study was to compare the rate of actionable arrhythmic events between patients with hypertrophic cardiomyopathy (HCM) who are monitored with an insertable cardiac monitor (ICM) or Holter monitoring.
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