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Prevention of hypertrophic cardiomyopathy-related deaths: theory and practice
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  • Published on:
    Risk assessment in HCM

    Sir, I was interested in Elliott and Spirito's lucid description of the arrhythmogenic substrate in HCM (1) in their recent review article. Although they quote no evidence for their assertions, I have advanced this hypothesis on many occasions in the last 16 years and have gathered substantial clinical evidence that is consistent with the electrophysiological effects of disarray leading to lethal arrhythmias.


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    Conflict of Interest:
    None declared.
  • Published on:
    Risk assessment in HCM

    Sir, I was interested to note the omission from the review by Elliot and Spirito (1) of an important paper by Saumarez and colleagues (2) describing an electrophysiological method of risk assessment in hypertrophic cardiomyoptahy(2). The substrate for sudden death is almost certainly fibre disarray and fibrosis. Based on this knowledge, Saumarez and colleagues in 1992 (1) hypothesised that pacing induced electrogram fra...

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    Conflict of Interest:
    None declared.