Mariusz Klopotowski1, Aleksandra Kwapiszewska1, Krzysztof Kukula1, Jacek Jamiolkowski2, Maciej Dabrowski1, Pawel Derejko3, Artur Oreziak4, Rafal Baranowski4, Mateusz Spiewak5, Magdalena Marczak5, Anna Klisiewicz6, Barbara Szepietowska7, Zbigniew Chmielak1, Adam Witkowski1. 1. Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland. 2. Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, Bialystok, Poland. 3. Department of Cardiology and Internal Medicine, Medicover Hospital, Warsaw, Poland. 4. Department of Cardiac Arrhythmias, Institute of Cardiology, Warsaw, Poland. 5. Magnetic Resonance Unit, Institute of Cardiology, Warsaw, Poland. 6. Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland. 7. Department of Medicine, Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York.
Abstract
BACKGROUND: Atrial fibrillation (AF) is a common complication in patients with hypertrophic cardiomyopathy (HCM) and may contribute to high cardiovascular morbidity and mortality. Therefore, it is important to assess parameters associated with AF in HCM patients. HYPOTHESIS: The aim of the study was to evaluate AF prevalence in patients with HCM and to investigate risk factors for AF. METHODS: Five hundred and forty-six HCM patients aged below 65 were included into analysis. Clinical and echocardiographic parameters were analyzed. RESULTS: In 141 patients (25.8%) AF episodes were recorded. The following factors were identified as risk factors for AF in patients with HCM: age ≥ 45 years (OR 2.38, CI 1.40-4.05, P = 0.001), past history of presyncope or syncope (OR 2.25, CI 1.35-3.74, P = 0.002), non-sustained ventricular tachycardia (nsVT) (OR 2.70, CI 1.60-4.57, P < 0.001), left atrium diameter during first assessment (OR 1.065, CI 1.03-1.11, P = 0.001), left atrium diameter at the last assessment before AF occurrence (OR 1.10, CI 1.06-1.14, P < 0.001) and left ventricular ejection fraction at the last assessment before AF occurrence (CI 0.96, CI 0.94-0.98, P = 0.001). CONCLUSIONS: We confirm that AF is a common complication for patients with HCM. Identification of patients with high risk for AF and implementation of preventive strategies may reduce AF occurrence and its complications.
BACKGROUND:Atrial fibrillation (AF) is a common complication in patients with hypertrophic cardiomyopathy (HCM) and may contribute to high cardiovascular morbidity and mortality. Therefore, it is important to assess parameters associated with AF in HCM patients. HYPOTHESIS: The aim of the study was to evaluate AF prevalence in patients with HCM and to investigate risk factors for AF. METHODS: Five hundred and forty-six HCM patients aged below 65 were included into analysis. Clinical and echocardiographic parameters were analyzed. RESULTS: In 141 patients (25.8%) AF episodes were recorded. The following factors were identified as risk factors for AF in patients with HCM: age ≥ 45 years (OR 2.38, CI 1.40-4.05, P = 0.001), past history of presyncope or syncope (OR 2.25, CI 1.35-3.74, P = 0.002), non-sustained ventricular tachycardia (nsVT) (OR 2.70, CI 1.60-4.57, P < 0.001), left atrium diameter during first assessment (OR 1.065, CI 1.03-1.11, P = 0.001), left atrium diameter at the last assessment before AF occurrence (OR 1.10, CI 1.06-1.14, P < 0.001) and left ventricular ejection fraction at the last assessment before AF occurrence (CI 0.96, CI 0.94-0.98, P = 0.001). CONCLUSIONS: We confirm that AF is a common complication for patients with HCM. Identification of patients with high risk for AF and implementation of preventive strategies may reduce AF occurrence and its complications.
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