uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Causes of death and mortality in hypertrophic cardiomyopathy patients with implantable defibrillators in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Cardiol Res Unit, Dept Med, Stockholm, Sweden..
Karolinska Inst, Cardiol Res Unit, Dept Med, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
Umea Univ, Ctr Heart, Umea, Sweden.;Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
2016 (English)In: Journal of Cardiovascular Medicine, ISSN 1558-2027, E-ISSN 1558-2035, Vol. 17, no 7, 478-484 p.Article in journal (Refereed) PublishedText
Abstract [en]

AimsImplantable defibrillators (ICDs) successfully terminate ventricular arrhythmias in hypertrophic cardiomyopathy (HCM), protect against bradycardia, and monitor atrial arrhythmias. This may alter the natural history and causes of death.MethodsThis nationwide observational longitudinal retrospective study of all HCM patients implanted during 1995-2012 obtained data from the Swedish ICD Registry, the National Patient Register, the Cause of Death Register, and were validated by review of medical records.ResultsOf 342 patients (mean age 51.8 years, 70.8% males), 45 died during a total follow-up of 1847 years (mean 5.4 years). Mean age at death was 68.2 years (range 21-83 years; 12 were 75 years). Mean follow-up time among the deceased was 4.9 years (quartiles 1.4-7.4 years). All-cause mortality was higher in HCM patients compared with the age and sex-matched Swedish general population (standardized mortality ratio 3.4; 95% confidence interval 2.4-4.5; P<0.001). Main cause of death was heart failure (n=27), stroke (n=5), cancer (n=3), myocardial infarction (n=2), sepsis (n=2), and others (n=4). Two patients died suddenly, one after the ICD was turned off because of inappropriate shocks, and one patient whose device system was removed after infection. HCM was the main cause of death in 76% of the cases, mainly because of progressive heart failure.ConclusionFor HCM patients, ICDs almost eliminate premature arrhythmic death and result in a shift to heart failure as the cause of death in the majority of cases. Still, mortality in HCM patients remains elevated and management of heart failure and comorbidities must be improved to increase survival.

Place, publisher, year, edition, pages
2016. Vol. 17, no 7, 478-484 p.
Keyword [en]
epidemiology, heart failure, hypertrophic cardiomyopathy, implantable defibrillator, mortality
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-299557DOI: 10.2459/JCM.0000000000000359ISI: 000377826800004PubMedID: 26808417OAI: oai:DiVA.org:uu-299557DiVA: diva2:949807
Available from: 2016-07-25 Created: 2016-07-22 Last updated: 2016-07-25Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Liv, Per
By organisation
Centre for Research and Development, Gävleborg
In the same journal
Journal of Cardiovascular Medicine
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 3 hits
ReferencesLink to record
Permanent link

Direct link