Journal article
Risk factors for lethal arrhythmic events in children and adolescents with hypertrophic cardiomyopathy and an implantable defibrillator: An international multicenter study
Heart rhythm, Vol.16(10), pp.1462-1467
10/2019
DOI: 10.1016/j.hrthm.2019.04.040
PMID: 31026510
Abstract
Predictors of risk of lethal arrhythmic events (LAE) is poorly understood and may differ from adults in children with hypertrophic cardiomyopathy (HCM).
The purpose of this study was to determine predictors of LAE in children with HCM.
A retrospective data collection was performed on 446 children and teenagers 20 years and younger (290 [65%] male; mean age 10.1 ± 5.7 years) with idiopathic HCM from 35 centers. Patients were classified as group 1 (HCM with LAE) if having a secondary prevention implantable cardioverter-defibrillator (ICD) or primary prevention ICD with appropriate interventions or group 2 (HCM without LAE) if having a primary prevention ICD without appropriate interventions.
There were 152 children (34%) in group 1 and 294 (66%) in group 2. Risk factors for group 1 by univariate analysis were septal thickness, posterior left ventricular (LV) wall thickness, lower LV outflow gradient, and Q wave > 3 mm in inferior electrocardiographic leads. Factors not associated with LAE were family history of SCD, abnormal blood pressure response to exercise, and ventricular tachycardia on ambulatory electrocardiographic monitoring. Risk factors for SCD by multivariate analysis were age at ICD placement (hazard ratio [HR] 0.9; P = .0025), LV posterior wall thickness z score (HR 1.02; P < .005), and LV outflow gradient < 30 mm Hg (HR 2.0; P < .006). LV posterior wall thickness z score ≥ 5 was associated with LAE.
Risk factors for LAE appear different in children compared to adults. Conventional adult risk factors were not significant in children. Further prospective studies are needed to improve risk stratification for LAE in children with HCM.
Details
- Title: Subtitle
- Risk factors for lethal arrhythmic events in children and adolescents with hypertrophic cardiomyopathy and an implantable defibrillator: An international multicenter study
- Creators
- Seshadri Balaji - Oregon Health & Science UniversityMichael P. DiLorenzo - Children's Hospital of PhiladelphiaFrank A. Fish - Vanderbilt UniversitySusan P. Etheridge - University of UtahPeter F. Aziz - Cleveland ClinicMark W. Russell - C. S. Mott Children's HospitalSvjetlana Tisma - Mercy Children's HospitalAndreas Pflaumer - Royal Children's HospitalNarayanswami Sreeram - University of ColognePeter Kubus - University Hospital in MotolIan H. Law - University of IowaMichal J. Kantoch - University of AlbertaNaomi J. Kertesz - Nationwide Children's HospitalMargaret Strieper - Sibley Heart Center, Atlanta, GeorgiaChristopher C. Erickson - Children's Hospital & Medical CenterJeremy P. Moore - University of California, Los AngelesStephanie J. Nakano - University of Colorado DenverHarinder R. Singh - Children's Hospital of MichiganPhilip Chang - Children's Hospital of Los AngelesMitchell Cohen - Phoenix Children's HospitalAnne Fournier - Université de MontréalMaria V. Ilina - Royal Hospital for ChildrenRichard T. Smith - Carolinas Healthcare SystemFrank Zimmerman - Advocate Hospital, Chicago, IllinoisMichaela Horndasch - Deutsches Herzzentrum MünchenWalter Li - University of California, San FranciscoAnjan Batra - University of California, IrvineLeonardo Liberman - Columbia UniversityRobert Hamilton - Hospital for Sick ChildrenChristopher M. Janson - Montefiore Medical CenterShubhayan Sanatani - University of British ColumbiaIlana Zeltser - The University of Texas Southwestern Medical CenterGeorge McDaniel - University of VirginiaAndrew D. Blaufox - Hofstra UniversityJason M. Garnreiter - Saint Louis UniversityHannah Katcoff - Children's Hospital of PhiladelphiaMaully Shah - Children's Hospital of Philadelphia
- Resource Type
- Journal article
- Publication Details
- Heart rhythm, Vol.16(10), pp.1462-1467
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.hrthm.2019.04.040
- PMID
- 31026510
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Grant note
- Biotronik (https://doi.org/10.13039/501100005035) Medtronic (https://doi.org/10.13039/100004374) Ministry of Health (https://doi.org/10.13039/501100004726)
- Language
- English
- Date published
- 10/2019
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984353840902771
Metrics
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