Implantable cardioverter defibrillators in the context of hypertrophic cardiomyopathy: a lesson in patient autonomy

Jonathan James Hyett Bray, Chiara Bucciarelli-Ducci, Graham Stuart

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

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.

Original languageEnglish
JournalBMJ Case Reports
Volume2018
DOIs
Publication statusPublished - 5 Feb 2018

Keywords

  • Cardiomyopathy, Hypertrophic/complications
  • Comprehension
  • Death, Sudden, Cardiac/prevention & control
  • Decision Making
  • Defibrillators, Implantable
  • Female
  • Humans
  • Informed Consent
  • Middle Aged
  • Personal Autonomy
  • Primary Prevention
  • Risk Factors
  • Treatment Refusal

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