HCM-related Sudden Death rhythm?

[OnceAnEMT]

I didn't want to derail the topic that this originally came up in, but I have been wondering this for the past few days. In Sudden Death, and for my interest specifically in athletes during exertion, what rhythm is shown on the monitor? Is SCA, specifically from HCM, even an electrical issue? The cardiac tissue itself is the problem, yes, so would a shock even make a difference, even if it is a shockable rhythm?

Not to challenge the use of AEDs in this scenario, but I am really interested in the electrophysiology here. Thanks guys!

 

[Brandon O]

I would expect the usual. VT or VF, or asystole later on.

It is primarily electrical, which is why these healthy young things do well if someone can get in quickly with compressions and defibrillation. (They'll still have an underlying disease, of course, which needs addressing for the future... but as far as the arrest today, they can probably walk away if you let them.) They arrested because of a propensity for sudden arrhythmia, and today was the day when they finally entered a sustained pulseless rhythm. You can still knock 'em back out and they'll be back where they were ten minutes ago. If you're quick.