Prolonged EKG Monitoring Detects Relevant Arrhythmias in HCM

Apr 24, 2023

Juan Caro Codón, MD

Compared with standard EKG monitoring, prolonged EKG monitoring led to the detection of significantly more arrhythmias in patients with non-high-risk hypertrophic cardiomyopathy (HCM).

This was the main result of TEMPO-HCM, a prospective, observational, multicenter study, which assessed whether extended EKG monitoring (30 days) resulted in the detection of more relevant arrhythmias than standard 24-hour monitoring in patients with non-high-risk HCM. The relevant arrhythmias were atrial fibrillation (AF), non-sustained ventricular tachycardia (NSVT), and atrial flutter. All included patients who underwent 30-day EKG monitoring. Juan Caro Codón, MD, presented the results of the first 100 patients in the study at the 2023 European Heart Rhythm Association (EHRA) Congress, held from April 16 to 18, in Barcelona, Spain.¹

During the first 24 hours of monitoring, the detection rate of relevant arrhythmias was 11%, whereas 30 days of monitoring resulted in a detection rate of 65% (P<0.001). The effect of prolonged monitoring was mainly driven by increased detection of NSVTs, with 8% in 24 hours and 62% in 30 days (P<0.001). Dr. Caro Codón observed that there were six cases of AF detected after 24 hours and an additional four cases after 30 days.

“Although this result did not reach statistical significance, prolonged monitoring may have a role in the detection of AF in patients with HCM,” he said. Dr. Caro Codón emphasized that approximately 60% of patients in the study had NSVT, which warrants further investigation of its role as a risk factor for sudden cardiac death.