Why we may “never-ever” understand the seriousness of NSVT in HOCM ?

Hypertrophic cardiomyopathy (HCM) is the most common primary cardiac muscle disorder.It is one of the  extensively studied medical  entity in terms of pathology, genetics, electrophysiology and treatment.Though it has dramatic myocardial  phenotypic expression , longevity  can be near normal  except in a minority who are prone for LV dysfunction and SCD due to the indirect electrical instability.These arrhythmia arise due to myocardial disarray , micro vascular disease or fibrosis. NSVT  by definition is runs of VT at a rate of > 100 /mt occurring less than 30 seconds. How common is NSVT in HCM ? On Holter study with  178  patients  with HOCM (Adabag  JACC 2005 ) 90 % showed VPDs 12%  > 500 VPDs/24 h 40% had couplets, 30% had non-sustained ventricular tachycardia (NSVT). Over a follow-up of 5.5  6% patients died suddenly (annual mortality rate, 1.1%) For sudden death, NSVT on Holter ECG had negative and positive predictive values of 95% and 9%, and sensitivity and specificity of 45% and 69%, respectively. In this series from StGeorge hospital London from 630 patient incidence of NSVT was 19% and 4 episodes were observed in 48 hr in most .Monserrat L, JACC 2003 What is the duration , How fast  and  how frequent is the NSVT ? It is expected the total burden of NSVT would have a definite impact on outcome.  Curiously the duration, fastness and frequency of NSVT  was  not related to prognosis in atleast one study (Monserrat L, JACC 2003) Relationship bet...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: hocm hcm how to manage non sustained vt in hcm hoc hypertrophic cardiomyopathy icd for nsvt managment issues in hocm nsvt in hocm sustained vs nonsustained vt in hocm Source Type: blogs