7
Table 3. Suggested Competencies of Comprehensive and
Primary HCM Centers
Potential HCM Care
Delivery Competencies
Comprehensive
HCM Center
Primary
HCM Center
Referring Centers
and Physicians
AF catheter ablation
× ×
*
Initial management of
HFrEF and HFpEF
× × ×
Advanced HF
management (eg,
transplantation, CRT)
×
*
Pharmacological therapy
for HCM
× × ×
Invasive management of
symptomatic obstructive
HCM
×
†
Counseling occupational
and healthy living choices
other than high-intensity
or competitive activities
× × ×
Counseling options on
participation in high-
intensity or competitive
athletics
×
Managing women with
HCM through pregnancy
×
*
Management of
comorbidities
× × ×
* Optional depending on the core competencies of the institution.
†
If these procedures are performed, adequate quality assurance should be in place to
demonstrate outcomes consistent with that achieved by comprehensive centers.
AF indicates atrial fibrillation; CMR, cardiovascular magnetic resonance; COR, Class
of Recommendation; CRT, cardiac resynchronization therapy; HCM, hypertrophic
cardiomyopathy; HF, heart failure; HFpEF, heart failure with preserved ejection fraction;
HFrEF, heart failure with reduced ejection fraction; ICD, implantable cardioverter-
defibrillator; LVOTO, le ventricular outflow tract obstruction; SCD, sudden cardiac death;
and TTE, transthoracic echocardiography.
(cont'd)
