Multiple Cardiac Arrhythmias Detected by a Dual Chamber Implantable Cardioverter Defibrillator in a Patient with Hypertrophic Obstructive Cardiomyopathy

We present the case of a patient with hypertrophic obstructive cardiomyopathy (HOCM), with multiple risk factors for sudden cardiac death (SCD), who received a dual chamber implantable cardioverter-defibrillator (ICD). Within three weeks of implantation the patient experienced multiple ICD discharges. A review of the ICD strips, with a careful evaluation of the electrograms from the atrial (A) and ventricular (V) channels, revealed multiple simultaneous cardiac rhythm disturbances. This case highlights the importance of carefully risk stratifying these patients for SCD and the utility of a dual chamber ICD.

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