RT Journal Article
SR Electronic
T1 Implantable cardioverter defibrillators in the context of hypertrophic cardiomyopathy: a lesson in patient autonomy
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-223352
DO 10.1136/bcr-2017-223352
VO 2018
A1 Jonathan James Hyett Bray
A1 Chiara Bucciarelli-Ducci
A1 Graham Stuart
YR 2018
UL http://casereports.bmj.com/content/2018/bcr-2017-223352.abstract
AB Hypertrophiccardiomyopathy (HCM) is common, whereas the decision not to have an implantable cardioverterdefibrillator (ICD) when probably falling into a ‘high-risk’ category is not. A solicitor aged 45 years attended the inherited cardiac conditions clinic for review of her HCM and discussion about ICD implantation for primary prevention of sudden cardiac death (SCD). Despite a predicted 7% risk of SCD within the next 5 years, according to the European Society of Cardiology endorsed HCM Risk-SCD risk stratification tool, the patient opted against implantation of an ICD and comprehensively justifies her decision. This report discusses ethical aspects of a consultation offering ICD protection against SCD in the context of HCM and emphasises the clinicians’ role in respecting patient autonomy.