Does Treatment Influence the Natural History of Patients with Hypertrophic Cardiomyopathy?

Summary

Hypertrophic cardiomyopathy is a cardiac disorder of unknown aetiology which is characterised by hypertrophy of a non-dilated left ventricle, The course of hypertrophie cardiomyopathy may be relatively benign, but the risk of sudden death due to ventricular arrhythmias is an important clinical problem, Those patients at greatest risk of sudden death appear to be those with the combination of diagnosis in childhood, a family history of hypertrophie cardiomyopathy and sudden death, and syncopal episodes, The treatment of hypertrophie cardiomyopathy-associated ventricular tachycardia with ‘conventional’ antiarrhythmic agents (disopyramide, quinidine, mexiletine) has seldom been successful, However, treatment of this arrhythmia with amiodarone* in well-matched but non-parallel groups of patients has resulted in suppression of arrhythmia and improved survival compared with that seen with ‘conventional’ antiarrhythmic agents