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Failed Shocks in Patients with Hypertrophic Cardiomyopathy

      Implantable cardioverter-defibrillators (ICDs) are used in selected patients with Hypertrophic cardiomyopathy (HCM), who are considered at high risk for sudden cardiac death
      • Zeppenfeld K
      • Tfelt-Hansen J
      • de Riva M
      • et al.
      2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.
      ,
      • Ommen SR
      • Mital S
      • Burke MA
      • et al.
      2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
      . The unique anatomical features of this population raise concerns regarding the feasibility of successful defibrillation. Therefore, despite scarce evidence and advances in the design of contemporary ICDs, dual coil leads are still endorsed by some for HCM patients. Yet, this choice is associated with increased complication rate during lead extraction.

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      References:

        • Zeppenfeld K
        • Tfelt-Hansen J
        • de Riva M
        • et al.
        2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.
        Eur Heart J. Oct 21 2022; 43: 3997-4126
        • Ommen SR
        • Mital S
        • Burke MA
        • et al.
        2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
        Circulation. Dec 22 2020; 142: e558-e631
        • Kumar KR
        • Mandleywala SN
        • Madias C
        • Weinstock J
        • Rowin EJ
        • Maron BJ
        • Maron MS
        • Link MS
        Single Coil Implantable Cardioverter Defibrillator Leads in Patients With Hypertrophic Cardiomyopathy.
        Am J Cardiol. Jun 15 2020; 125: 1896-1900