New trends in treatment of hypertrophic cardiomyopathy.

摘要: The management of patients with hypertrophic cardiomyopathy (HCM) has evolved markedly over the past 20 years, particularly rising number indications for implantable cardiac defibrillators (ICDs) and alcohol septal ablation (ASA). However, medical therapies targeted to improve quality life are underused; when resting and/or exercise obstruction is present, an incremental additive approach should be used based on a high dosage beta-blockers, verapamil disopyramide. Radiofrequency catheter atrial fibrillation or A-V node been proposed in some instances. Treatment syncope presyncope due abnormal blood pressure response during remains challenging. Only who remain severely symptomatic despite maximal therapy considered invasive procedures, including dual-chamber (DDD) pacing, ASA surgery. reported complication rates (essentially complete block, incidence above 5-10%, mortality ranging from 0-4%) benefits at medium-term follow-up appear comparable those observed after myectomy, which, according guidelines, primary treatment most drug-refractory young obstruction. While overall survival HCM similar that general population, detection risk sudden death challenging, young, ICDs without prior arrest patient- family-orientated.