SCD Risk Stratification in Restrictive, Infiltrative and Rare Cardiomyopathies-SCD Risk Stratification in Restrictive, Infiltrative and Rare Cardiomyopathies

Video Transcription

Video Summary

Dr. Badi Fatun from Mayo Clinic discussed strategies for assessing sudden cardiac death risk in patients with hypertrophic obstructive cardiomyopathy (HOCM). The session began with a case study of a 29-year-old male experiencing cardiac symptoms following abnormal ECG findings. His family history included heart disease, raising concerns about the risk of sudden cardiac death. The discussion covered the incidence, risk factors, and guidelines, highlighting differences between U.S. and European approaches. Innovations in risk stratification, such as T1 mapping and genotype considerations, were emphasized as potentially significant.<br /><br />Subsequent speakers highlighted cardiac amyloidosis and sarcoidosis. Dr. Bharat Kantarina focused on cardiac amyloidosis, noting that while cardiac arrhythmias are common, ICDs for primary prevention might not be beneficial due to high mortality rates post-implantation. He emphasized that careful patient selection and shared decision-making are crucial, with novel disease-modifying treatments offering hope.<br /><br />Cardiac sarcoidosis was discussed by Dr. Jordana Krohn, who asserted that patients with high-degree AV block should receive ICDs regardless of ejection fraction. Cardiac MRI plays a significant role in risk stratification, with both the amount and pattern of late gadolinium enhancement being crucial. She covered device selection, with transvenous devices preferred, and highlighted programming considerations for ICDs given the complexity of arrhythmias in these patients.<br /><br />Finally, Dr. Enrico Amorati addressed idiopathic inflammatory cardiomyopathy and myocarditis, advocating for secondary prevention ICDs in patients presenting with sustained ventricular tachycardia. He stressed that specific genetic backgrounds could necessitate tailored approaches to risk assessment and treatment.

Keywords

sudden cardiac death

hypertrophic obstructive cardiomyopathy

risk stratification

cardiac amyloidosis

cardiac sarcoidosis

ICDs

T1 mapping

genotype considerations

cardiac MRI

inflammatory cardiomyopathy