Hakeem S K Ha1, Nelson Wang2, Sophia Wong1, Steven Phan2, Jace Liao2, Narendra Kumar3, Pierre Qian2,4, Tristan D Yan2,5, Kevin Phan6,7,8,9. 1. Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia. 2. Faculty of Medicine, University of Sydney, Sydney, Australia. 3. Department of Cardiology, Maastrict University Medical Center, Maastricht, The Netherlands. 4. Department of Cardiology, Westmead Hospital, Sydney, Australia. 5. The Collaborative Research (CORE) Group, Macquarie University, 2 Technology Place, Sydney, 2109, Australia. 6. Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia. kphan.vc@gmail.com. 7. Faculty of Medicine, University of Sydney, Sydney, Australia. kphan.vc@gmail.com. 8. Department of Cardiology, Westmead Hospital, Sydney, Australia. kphan.vc@gmail.com. 9. The Collaborative Research (CORE) Group, Macquarie University, 2 Technology Place, Sydney, 2109, Australia. kphan.vc@gmail.com.
Abstract
PURPOSE: The primary aim of this systematic review was to assess the efficacy of catheter ablation of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). Differentiation based off catheter ablation modalities was not considered due to the limited scope of the current field. Studies that employed alcohol septal ablation for the treatment of AF in HCM patients were excluded as were abstracts, case reports, conference presentations, editorials, reviews, and expert opinions METHODS: Electronic searches were performed in six databases from their inception until January 2014. Relevant studies regarding catheter ablation for AF in HCM populations were identified. Data was extracted and analyzed according to pre-defined clinical endpoints RESULTS: A review was undertaken of eight studies in which 241 HCM patients underwent catheter ablation for AF. Overall AF-free survival at last follow-up ranged from 47 to 77% (64-67%). Sinus rhythm was maintained at last follow-up in 47-82% (median 64-67%). AF recurrence ranged from 0 to 66% (median 35-40%). CONCLUSION: A review of the current evidence suggests that catheter ablation of AF in HCM patients is effective with suitable efficacy and is justified in select patients. Future adequately powered randomized studies should be undertaken aimed at addressing long-term efficacy and complications associated with procedural outcomes.
PURPOSE: The primary aim of this systematic review was to assess the efficacy of catheter ablation of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). Differentiation based off catheter ablation modalities was not considered due to the limited scope of the current field. Studies that employed alcohol septal ablation for the treatment of AF in HCM patients were excluded as were abstracts, case reports, conference presentations, editorials, reviews, and expert opinions METHODS: Electronic searches were performed in six databases from their inception until January 2014. Relevant studies regarding catheter ablation for AF in HCM populations were identified. Data was extracted and analyzed according to pre-defined clinical endpoints RESULTS: A review was undertaken of eight studies in which 241 HCM patients underwent catheter ablation for AF. Overall AF-free survival at last follow-up ranged from 47 to 77% (64-67%). Sinus rhythm was maintained at last follow-up in 47-82% (median 64-67%). AF recurrence ranged from 0 to 66% (median 35-40%). CONCLUSION: A review of the current evidence suggests that catheter ablation of AF in HCM patients is effective with suitable efficacy and is justified in select patients. Future adequately powered randomized studies should be undertaken aimed at addressing long-term efficacy and complications associated with procedural outcomes.
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