Journal Article

Arrhythmia substrate and management in hypertrophic cardiomyopathy: from molecules to implantable card ioverter-defibrillators

M.J. Janse and J.M.T. De Bakker

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 3, issue suppl_L, pages L15-L20
Published in print October 2001 | ISSN: 1520-765X
Published online October 2001 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/S1520-765X(01)90059-8
Arrhythmia substrate and management in hypertrophic cardiomyopathy: from molecules to implantable card ioverter-defibrillators

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Ventricular arrhythmias and sudden death are among the characteristics of hypertrophic cardiomyopathy. Experience with the implantable cardioverter-defibrillator has shown that sudden death is caused by ventricular tachycardia or fibrillation. Several triggers for sudden death have been proposed: arrhythmias; ischaemia; and abnormal response to exercise. The substrates for arrhythmias includes hypertrophy itself, predisposing to triggered activity based on delayed afterdepolarizations; fibrosis, leading to abnormal, zig-zag conduction and fractionated extracellular electrograms; and abnormal distribution of gap junctions, especially in areas of myofibrillar disarray, which also may lead to conduction abnormalities. The latter two factors predispose to re-entry.

Keywords: Triggered activity; delayed afterdepolarizations; fibrosis; abnormal gap junction distribution; re-entry

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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