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Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy.

Abstract：

BACKGROUND:Limited data exist regarding the outcome of atrial fibrillation (AF) surgery and catheter ablation in patients with hypertrophic cardiomyopathy (HCM). OBJECTIVE:The purpose of this study was to evaluate the safety and efficacy of nonpharmacologic treatment of AF in HCM. METHODS:One hundred forty-seven patients (46 female, age 55 ± 11 years, ejection fraction [EF] 58% ± 8%) with symptomatic paroxysmal (58%), persistent (31%), and long-standing persistent AF (11%) refractory to antiarrhythmic drugs who presented for their first catheter ablation (n = 79) or AF surgery (n = 68) were included. RESULTS:After follow-up of 35 months (interquartile range 13, 60), 29% of patients who underwent catheter ablation and 51% of those who had undergone AF surgery had no documented recurrent atrial arrhythmia after a single procedure. Repeat ablation was performed in 55% of patients with recurrent arrhythmia in the catheter group and 24% in the surgery group, increasing the success rate to 39% and 53%, respectively, after 1 or more procedures. Predictors of success after the first procedure in a multivariable setting included higher baseline EF and male gender. Persistent or long-standing AF and log of AF duration were associated with lower success. Major complications occurred in 6% of the catheter ablation group and 18% of the AF surgery group. During follow-up, 16 patients died (9 in catheter group, 7 in surgery group) and 1 underwent heart replacement. Lower baseline EF and older age were independently associated with death. CONCLUSION:Catheter ablation and AF surgery are associated with symptomatic improvement in HCM patients. However, long-term success is lower and complications are higher than previously reported.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Bassiouny M,Lindsay BD,Lever H,Saliba W,Klein A,Banna M,Abraham J,Shao M,Rickard J,Kanj M,Tchou P,Dresing T,Baranowski B,Bhargava M,Callahan T,Tarakji K,Cantillon D,Hussein A,Marc Gillinov A,Smedira NG,Wazni O

doi

10.1016/j.hrthm.2015.03.042

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

1438-47

issue

7

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(15)00341-0

journal_volume

12

pub_type

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