85. What are the indications for an implantable cardioverter defibrillator (ICD) in patients with hypertrophic obstructive cardiomyopathy (HOCM)?

Hypertrophic obstructive cardiomyopathy (HOCM) patients have a high risk of sudden cardiac death, however an implantable cardioverter defibrillator (ICD) is not recommend in all patients with HOCM. If any of the criteria below are present, then an ICD should be implanted:

1. Syncope
2. Interventricular septal thickness of 30 mm or greater
3. Documented ventricular tachycardia and/or cardiac arrest
4. Family history of sudden cardiac death
5. Left ventricular systolic dysfunction in the setting of wall thinning (a.k.a. “burnt out” left ventricle)