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.
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.
Authors: Sana M Al-Khatib; Emelia J Benjamin; Alfred E Buxton; Hugh Calkins; Mina K Chung; Anne B Curtis; Patrice Desvigne-Nickens; Pierre Jais; Douglas L Packer; Jonathan P Piccini; Yves Rosenberg; Andrea M Russo; Paul J Wang; Lawton S Cooper; Alan S Go Journal: Circulation Date: 2019-11-20 Impact factor: 29.690
Authors: Ahmad Masri; Mohamed Kanj; Maran Thamilarasan; Oussama Wazni; Nicholas G Smedira; Harry M Lever; Milind Y Desai Journal: Cardiovasc Diagn Ther Date: 2017-02
Authors: Nadia H Bakir; Robert M MacGregor; Ali J Khiabani; Farah N Musharbash; Matthew R Schill; Laurie A Sinn; Richard B Schuessler; Spencer J Melby; Marye J Gleva; Ralph J Damiano Journal: Ann Thorac Surg Date: 2021-03-01 Impact factor: 5.102
Authors: Guy Rozen; Gabby Elbaz-Greener; Ibrahim Marai; Nizar Andria; Seyed Mohammadreza Hosseini; Yitschak Biton; E Kevin Heist; Jeremy N Ruskin; Yulia Gavrilov; Shemy Carasso; Diab Ghanim; Offer Amir Journal: J Am Heart Assoc Date: 2020-06-23 Impact factor: 5.501
Authors: Leon Dinshaw; Paula Münkler; Benjamin Schäffer; Niklas Klatt; Christiane Jungen; Jannis Dickow; Annika Tamenang; Ruben Schleberger; Simon Pecha; Hans Pinnschmidt; Monica Patten; Hermann Reichenspurner; Stephan Willems; Christian Meyer Journal: J Am Heart Assoc Date: 2021-01-17 Impact factor: 5.501