Asystole and scarring of the interventricular septum in hypertrophic cardiomyopathy

We present the case of a 60-year-old woman who presented with syncope in the context of a diagnosis of hypertrophic cardiomyopathy. She had no high-risk features of ventricular tachycardia. An implantable loop recorder showed episodic asystole, with evidence of late enhancement on cardiovascular magnetic resonance in the basal septum, suggestive of fibrosis of the conducting system. J Cardiovasc Med 10:349-351 (C) 2009 Italian Federation of Cardiology.