Surface fragmented QRS in a patient with hypertrophie cardiomyopathy and malignant arrhythmias: ls there an association?

An 18- year old woman with hypertrophie cardiomyopathy, aborted sudden cardiac death and implanted with an implantable cardioverter defibrillator (ICD), developed progressive fragmentation of her surface 12-lead electrocardiogram (ECG). During the follow-up, she presented with multiple appropriate ICD discharges. Here, we discuss the possible association between surface fragmented ECG and the risk of ventricular arrhythmias in patients with hypertrophie cardiomyopathy.