Abstract
The prevalence of potentially lethal arrhythmias (PLA) in groups of patients with hypertrophic cardiomyopathy has been assessed, but the rate at which they develop (their incidence) during long-term follow-up has not been reported. Therefore, conduction system disease (CSD) (sick sinus syndrome and His-ventricular disease), ventricular couplets and ventricular tachycardia (VT) detected by routine electrocardiograms, periodic 24-hour Holter monitoring and periodic exercise stress testing were studied in 50 patients treated with large doses of beta-adrenergic blocking drugs who were followed for 2 to 14 years (mean 5.9). Sixteen PLAs detected at the beginning of observation were excluded from actuarial analysis for new PLAs . Twenty-one patients had 24 new PLAs (7 with CSD, 1 patient with sustained supraventricular tachycardia, 6 with ventricular couplets and 10 with VT); only 43% of these PLAs were heralded by new symptoms. In 6 patients, the arrhythmia caused symptoms and was identified by a routine electrocardiogram. The 3 patients with His-ventricular disease presented with syncope and required electrophysiologic confirmation of this diagnosis. In only 1 patient was a PLA (ventricular couplets) detected only by exercise testi...Continue Reading
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