IS SUDDEN CARDIAC DEATH PREDICTABLE IN OB STRUCTIVE AND NONOBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY

Sudden cardiac death constitutes the most devastating aspect of obstru ctive and nonobstructive hypertrophic cardiomyopathy. Loss of consciou sness and family history of sudden cardiac death should alert the phys ician to the risk of sudden death. EGG, morphological and hemodynamic assessment, and exploration of central nervous activity are of little use in stratifying the risk of sudden cardiac death. Loss of conscious ness associated with nonsustained ventricular tachycardia and inducibl e sustained ventricular arrhythmia identify patients at very high risk of sudden cardiac death. Nevertheless, many variable factors are invo lved in the pathophysiology of sudden cardiac death, and hence risk st ratification of sudden cardiac death in patients with hypertrophic car diomyopathy remains a very difficult clinical challenge.