Table 1.

Clinical and diagnostic criteria of patients must fulfil before progression to ASA

Category	Criteria for progression to ASA
Diagnosis	Clinician must be satisfied that the pathology is genetically determined hypertrophic cardiomyopathy in the absence of other causes of LVH
Symptom status	NYHA III dyspnoea
	NYHA II with non-arrhythmic pre-syncope or chest pain
Medications	Symptoms refractory to an adequate trial of negatively inotropic medications
LVOT gradient	≥50 mmHg at rest, Valsalva manoeuvre or with exercise stress
	LVOT gradient must be due to SAM of the MV. Causes such as sub-aortic band and anomalous papillary muscle architecture must be ruled out
Septal size	≥15 mm in diastole
Alternative indication for surgery	Rule out coronary artery disease, sub-aortic band or MV abnormalities requiring surgical intervention
RV apical pacing	Trial of RV pacing if dual-chamber device already in situ
Functional testing	>50% predicted FEV1 and FVC on PFTs
	<90% predicted peak VO2 on CPEX testing
	Cardiac restriction on CPEX testing