The role of pharmacologic treatment to prevent sudden death in the implantable cardioverter defibrillator era.

The prevention of sudden death remains a key aspect of clinical management in patients with hypertrophic cardiomyopathy (HCM). For many years, amiodarone has been widely used to treat and prevent symptomatic atrial arrhythmias in patients with HCM, but its role in the prevention of potentially fatal ventricular arrhythmia has remained controversial. The publication of several observational studies examining the efficacy of implantable cardioverter defibrillators (ICDs) in patients with the disease has stimulated a re-evaluation of the drug's place in the management of HCM. This article reviews the literature on amiodarone therapy in HCM and discusses the indications for its use in the ICD era.