Arrhythmias and Hypertrophic Cardiomyopathy: Unravelling the Connection.

IF 2.4 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Kanishk Aggarwal, Sri Pranvi Boyapati, Jayesh Valecha, Amna Noor, Fnu Kanwal, Rohit Jain, Sai Gautham Kanagala
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引用次数: 0

Abstract

Hypertrophic cardiomyopathy (HCM) results from gene mutations affecting cardiac sarcomeres and is inherited in an autosomal dominant manner. With a prevalence of 1:200-1:500 in the general population, HCM is characterised by a hypertrophied and non-dilated left ventricle with predominant involvement of the interventricular septum. The myocardium's structural and intracellular factors, combined with triggers such as physical exertion, autonomic dysfunction, and ischemia, can lead to reentry events, and atrial and ventricular arrhythmias, including atrial fibrillation (AF) which is common among HCM patients. To manage the increased risk of mortality arising from congestive heart failure and thromboembolism, in patients with AF long-term anticoagulation and antiarrhythmic drugs are employed. HCM patients may also encounter supraventricular and ventricular arrhythmias, such as nonsustained ventricular tachycardia and ventricular premature beats, which can potentially lead to sudden cardiac death and necessitate treatment with implanted defibrillators. Physicians must comprehensively analyse clinical, anatomical, hemodynamic, rhythmic, functional, and genetic characteristics to identify HCM patients at high risk of sudden death. This article aims to discuss the pathophysiology of arrhythmia in HCM and clinical recommendations for various ventricular and atrial fibrillation including catheter ablation and implantable cardioverter-defibrillator (ICD).

心律失常与肥厚型心肌病:解开其中的联系。
肥厚型心肌病(HCM)是由影响心肌细胞的基因突变引起的,为常染色体显性遗传。肥厚型心肌病在普通人群中的发病率为 1:200-1:500,其特征是左心室肥厚且不扩张,室间隔主要受累。心肌的结构和细胞内因素与体力消耗、自主神经功能障碍和缺血等诱因相结合,可导致再入事件、心房和心室心律失常,包括 HCM 患者中常见的心房颤动(房颤)。为了控制因充血性心力衰竭和血栓栓塞而增加的死亡风险,房颤患者需要长期服用抗凝和抗心律失常药物。HCM 患者还可能出现室上性和室性心律失常,如非持续性室性心动过速和室性早搏,这有可能导致心脏性猝死,因此必须使用植入式除颤器进行治疗。医生必须全面分析临床、解剖、血流动力学、节律、功能和遗传特征,以识别猝死风险高的 HCM 患者。本文旨在讨论 HCM 患者心律失常的病理生理学以及各种室颤和房颤的临床建议,包括导管消融和植入式心律转复除颤器 (ICD)。
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来源期刊
Current Cardiology Reviews
Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
10.50%
发文量
117
期刊介绍: Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
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