Primary Prevention of Sudden Death as a Novel Treatment Strategy in Hypertrophic Cardiomyopathy

Case Report: A 20-year-oldasymptomatic man was diag-nosed with hypertrophic cardio-myopathy (HCM) after routine physical examination during which a systolic heart murmur was detected. Echocardiography showed massive left ventricular (LV) hy-pertrophy with ventricular septal thickness of 36 mm extending into the anterolateral wall (30 mm); outflow obstruction was absent. Ambulatory (Holter) ECG showed 3 isolated premature ventricular contrac-tions, and blood pressure response to exer-cise was normal. Echocardiographic ex-aminations in parents and siblings were negative for HCM. Although 2 centers advised against an implantabl