ArticleHeart rhythm O22026
Myocardial fibrosis predicts sudden cardiac death in patients with hypertrophic cardiomyopathy after cardiac electronic device implantation: Insights from cardiovascular magnetic resonance imaging.
Article in Heart rhythm O2, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Patients with hypertrophic cardiomyopathy (HCM) face an increased risk of sudden cardiac death (SCD), and myocardial fibrosis is predictive of ventricular arrhythmias. Objective: This study aimed to determine whether the location, pattern, and quantification of myocardial fibrosis predict SCD in patients with HCM after cardiac implantable electronic device (CIED) implantation. Methods: This study included patients with HCM who completed cardiovascular magnetic resonance and received CIED between June 2017 and January 2023. The primary outcome was SCD or SCD-equivalent events (composite of SCD, resuscitated cardiac arrest, sustained ventricular tachycardia or ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy). Results: 88 patients were included (age 52.3 ± 15.3 years; 67.0% male). Over a median follow-up period of 38.1 months, 27 SCD events (30.6%) were recorded. Fibrosis in the inferior wall, transmural pattern, total fibrosis, and gray zone fibrosis (GZF) were all significantly associated with SCD risk. Stepwise regression analyses identified the transmural fibrosis pattern (hazard ratio 3.15; 95% confidence interval [CI] 1.22-8.14; Conclusion: Transmural fibrosis and elevated GZF
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