ABC | Volume 110, Nº6, June 2018

Original Article Reis et al Hypertrophic Cardiomyopathy Arq Bras Cardiol. 2018; 110(6):524-531 Figure 2 – Comparison of the occurrence of dysrhythmic events during clinical follow-up. 100% 80% 60% 40% 20% 0% Without ICD With ICD 4.9% 0.0% 20.0% 42.9% 100.0% 100.0% 50.0% 16.0% 50.0% 33.3% III 2011/14 (n = 64) IIa 2011/14 (n = 13) Total (n = 105) IIa (2011) and III (2014) (n = 17) IIa (2011) and IIb (2014) (n = 11) Dysrhythmic events Table 2 – Comparison of dysrhythmic events in the different groups Groups Dysrhythmic events Total p No Yes III in 2011 and 2014 ICD No N % 58 / 95.1 3 / 4.9 61 / 100 1.00 Yes N % 3 / 100 0 / 0 3 / 100 1.00 Total N % 61 / 95.3 3 / 4.7 64 / 100 1.00 IIa in 2011 and III in 2014 ICD No N % 8 / 80.0 2 / 20.0 10 / 100 0.59 Yes N % 4 / 57.1 3 / 42.9 7 / 100 Total N % 12 / 70.5 5 / 29.4 17 / 100 0.59 IIa in 2011 and IIb in 2014 ICD No N % 7 / 100 7 / 100 1.00 Yes N % 4 / 100 4 / 100 Total N % 11 / 100 11 / 100 1.00 IIa in 2011 and 2014 ICD No N % 2 / 66.7 1 / 33.3 3 / 100 Yes N % 5 / 50.0 5 / 50.0 10 / 100 Total N % 7 / 53.8 6 / 46.2 13 / 100 1.00 TOTAL ICD No N % 68 / 84.0 13 / 46.2 81 / 100 0.001 Yes N % 12 / 50.0 12 / 50.0 24 / 100 Total N % 80 / 76.2 25 / 23.8 105 / 100 0.001 1 (33.3%) had VT during follow-up. Of the 10 receiving an ICD, 5 (50,0%) had dysrhythmic events. The groups with and without ICD were compared regarding the percentages of events, but no statistical difference was found between them (p = 1.00) – Table 2. Of the total population of 105 patients, those who underwent and those who did not undergo ICD implantation for primary prevention were compared regarding the percentages of events. Of the 81 patients who did not receive an ICD, 13 (16.0%) had dysrhythmic events. Of the 24 patients with an ICD, 12 (50.0%) had VT/ventricular fibrillation. Comparing the percentages of events in the two groups, there was a statistically significant difference (p = 0.001) – Table 2. Discussion Our sample of ‘real world’ patients with HCM had a 22.6% prevalence of ICD implantation. The proportion of patients with HCM and indication for ICD for primary prevention significantly decreased when comparing the 2011 and 2014 guidelines. During clinical follow-up, we detected the presence of complex ventricular dysrhythmia on Holter and/or ICD in some patients, of whom only a minority had a risk score of SCD due to HCM > 6%. In our population, 1 patient with a score < 4%/5 years died due to ventricular fibrillation. According to the literature, in Portugal, no other center has published a study with which we could compare our data and experience. 528