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

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

doi:10.1136/bcr-2017-223352

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 journal › Article (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 language	English
Journal	BMJ Case Reports
Volume	2018
DOIs	https://doi.org/10.1136/bcr-2017-223352
Publication status	Published - 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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title = "Implantable cardioverter defibrillators in the context of hypertrophic cardiomyopathy: a lesson in patient autonomy",

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.",

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author = "Bray, {Jonathan James Hyett} and Chiara Bucciarelli-Ducci and Graham Stuart",

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doi = "10.1136/bcr-2017-223352",

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T1 - Implantable cardioverter defibrillators in the context of hypertrophic cardiomyopathy

T2 - a lesson in patient autonomy

AU - Bray, Jonathan James Hyett

AU - Bucciarelli-Ducci, Chiara

AU - Stuart, Graham

PY - 2018/2/5

Y1 - 2018/2/5

N2 - 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.

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.

KW - Cardiomyopathy, Hypertrophic/complications

KW - Comprehension

KW - Death, Sudden, Cardiac/prevention & control

KW - Decision Making

KW - Defibrillators, Implantable

KW - Female

KW - Humans

KW - Informed Consent

KW - Middle Aged

KW - Personal Autonomy

KW - Primary Prevention

KW - Risk Factors

KW - Treatment Refusal

U2 - 10.1136/bcr-2017-223352

DO - 10.1136/bcr-2017-223352

M3 - Article (Academic Journal)

C2 - 29437742

SN - 1757-790X

VL - 2018

JO - BMJ Case Reports

JF - BMJ Case Reports

ER -

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

Abstract

Keywords

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