Recurrent presyncope is occasionally reported by patients with hypertrophic cardiomyopathy (HC). However, it is difficult to identify on 24-hour Holter recordings the mechanisms responsible for these infrequent symptoms. We report the case of a patient with HC with recurrent presyncope and without major sudden death risk factors, in whom electrocardiographic loop recording identified life-threatening arrhythmias as the mechanism responsible for these symptoms. Documentation of these arrhythmias justified implantation of a cardioverter-defibrillator in the absence of other risk factors.
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