HCM Risk SCD
Step 1: Prior SCD, VF, or sustained VT ?
Step 2: 1 of the following?
Step 3: 5-Year risk estimate for shared decision making
This tool estimates the 5-year risk of sudden cardiac death in patients aged 16 years and older following their initial evaluation.
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It should not be used for
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Pediatric patients (those younger than 16 years)
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Elite or competitive athletes
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Individuals with metabolic diseases or syndromes associated with a diagnosis of hypertrophic cardiomyopathy (HCM).
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Sudden cardiac death in first-degree relatives under 40 or in any relative with confirmed hypertrophic cardiomyopathy.
The maximum thickness of the anterior septum, posterior septum, lateral wall, and posterior wall of the left ventricle (LV) was measured at the level of the mitral valve, papillary muscles, and apex. This was performed using 2-D echocardiography in the parasternal short-axis view at the time of evaluation.
Determined by M-Mode or 2-D echocardiography in the parasternal long-axis view at the time of evaluation.
Peak outflow tract gradients were calculated using the equation: Gradient = 4V², where V is the peak aortic outflow velocity. Measurements were taken at rest and during Valsalva provocation using Doppler from apical 3-chamber and 5-chamber views.
Three or more consecutive ventricular beats at a rate of 120 bpm or higher and lasting less than 30 seconds on Holter monitoring (minimum duration of 24 hours) prior to or at the time of evaluation.
History of unexplained fainting episodes occurring at or before the evaluation.
An ICD is recommended.
An ICD is reasonable.
An ICD is may be considered.
An ICD is not indicated. (Harm)
References
O'Mahony C, Jichi F, Pavlou M, Monserrat L, Anastasakis A, Rapezzi C, Biagini E, Gimeno JR, Limongelli G, McKenna WJ, Omar RZ, Elliott PM; Hypertrophic Cardiomyopathy Outcomes Investigators. A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). Eur Heart J. 2014 Aug 7;35(30):2010-20.
Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB; Peer Review Committee Members. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Jun 4;149(23):e1239-e1311.