Abstract | BACKGROUND: OBJECTIVE: METHODS: Among 63 patients with HCM and appropriate device interventions, 126 intracardiac electrograms were assessed for the hourly distribution of VT/VF. RESULTS: One or more arrhythmic episodes occurred in each hour of the day, and a modest pattern of circadian variability was evident. VT/VF episodes were more common in the afternoon and evening hours from noon to midnight (64%) than in the other 12-hour period (36%; P = .008), with the suggestion of a peak at 2 to 4 PM. A sizeable proportion of events (27%) occurred during the potential sleeping hours of 11 PM and 7 AM. CONCLUSION: In high-risk HCM patients, the afternoon and evening circadian periodicity of ventricular tachyarrhythmias (terminated by the ICD) underscores the largely unpredictable nature of the electrophysiologic substrate in this disease, and differs from the pattern of early morning cardiovascular events reported in ischemic heart disease. These observations also suggest that home automatic defibrillator strategies for sudden death prevention are unlikely to be effective in HCM.
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Authors | Barry J Maron, Christopher Semsarian, Win-Kuang Shen, Mark S Link, Andrew E Epstein, N A Mark Estes 3rd, Adrian Almquist, Michael C Giudici, Tammy S Haas, James S Hodges, Paolo Spirito |
Journal | Heart rhythm
(Heart Rhythm)
Vol. 6
Issue 5
Pg. 599-602
(May 2009)
ISSN: 1556-3871 [Electronic] United States |
PMID | 19332391
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Topics |
- Adolescent
- Adult
- Aged
- Australia
(epidemiology)
- Cardiomyopathy, Hypertrophic
(complications, physiopathology, therapy)
- Child
- Child, Preschool
- Circadian Rhythm
(physiology)
- Defibrillators, Implantable
(adverse effects)
- Electric Countershock
(adverse effects, methods)
- Electrophysiologic Techniques, Cardiac
- Female
- Follow-Up Studies
- Heart Rate
(physiology)
- Humans
- Incidence
- Male
- Middle Aged
- Risk Factors
- Tachycardia, Ventricular
(epidemiology, etiology, physiopathology)
- Treatment Outcome
- United States
(epidemiology)
- Young Adult
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