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Predicting therapies in Japanese hypertrophic cardiomyopathy patients with an implantable cardioverter–defibrillator using the 2014 European Society of Cardiology guidelines

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Abstract

Previous studies have shown that the sudden cardiac death (SCD) prediction model proposed by the 2014 European Society of Cardiology (ESC) guideline (5-Year Risk-SCD) was validated in European patients with hypertrophic cardiomyopathy (HCM). However, there are limited data on Asian patients with HCM. We assessed the validity of the estimated 5-Year Risk-SCD in Japanese HCM patients with an implantable cardioverter–defibrillator (ICD) using the2014 ESC guidelines. We retrospectively examined data of 492 consecutive Japanese patients with an ICD. Sixty-two Japanese HCM patients with an ICD were enrolled in this study, and 50 patients (81%) were followed up for ≥ 5 years. We analyzed the characteristics and outcomes of these 50 patients. We investigated the incidence of appropriate ICD therapy as categorized by the ESC guideline and compared the 5-Year Risk-SCD with the 5-year rate of appropriate shock therapies. Based on the 2012 Japanese Circulation Society guideline and the 2011guidelines of the American Heart Association and American College of Cardiology Foundation, 10 and 40 patients met classes I and IIa of the ICD recommendation, respectively. However, only 18 (36%) patients were classified into class I or IIa of the ESC guideline. Among 50 patients followed up for ≥ 5 years after ICD implantation, the incidences of appropriate ICD therapies for classes I, IIa, IIb, and III indications based on the 2014 ESC guideline were 50%, 38%, 17%, and 0%, respectively. Risk stratification for SCD using 5-Year Risk-SCD is valid in Japanese HCM patients with an ICD, and the 2014 ESC guideline might be useful for the indication of ICD implantation in Japan.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Miyo Nakano, Yusuke Kondo, Kazuo Miyazawa, Tomohiko Hayashi, Ryo Ito, Haruhiro Takahira & Yoshio Kobayashi

  2. Department of Advanced Cardiorhythm Therapeutics, Chiba University Graduate School of Medicine, Chiba, Japan

    Masahiro Nakano & Takatsugu Kajiyama

Authors
  1. Miyo Nakano
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  2. Yusuke Kondo
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  3. Masahiro Nakano
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  4. Takatsugu Kajiyama
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  5. Kazuo Miyazawa
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  6. Tomohiko Hayashi
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  7. Ryo Ito
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  8. Haruhiro Takahira
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  9. Yoshio Kobayashi
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Correspondence to Yusuke Kondo.

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Conflict of interest

Dr. Kondo received research grants from Boston Scientific Japan, Japan Lifeline, MSD Japan, and Abbott Japan. Dr. Kobayashi received research grants from Medtronic Japan, Abbott Japan, Boston Scientific Japan, and Japan Lifeline. Dr. Nakano and Dr. Kajiyama belong to the endowed department sponsored by Abbott Japan and Biotronik Japan. Dr. Kondo received donations and scholarship funds from Daiichi-Sankyo.

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The hospital’s ethics committee approved this study, and the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Nakano, M., Kondo, Y., Nakano, M. et al. Predicting therapies in Japanese hypertrophic cardiomyopathy patients with an implantable cardioverter–defibrillator using the 2014 European Society of Cardiology guidelines. Heart Vessels 36, 99–104 (2021). https://doi.org/10.1007/s00380-020-01668-z

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