AIMS: Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with hypertrophic cardiomyopathy (HCM), and is associated with deterioration in clinical status and outcome. To date, no data have been published pertaining to AF in an Irish HCM population. METHODS AND RESULTS: 159 patients with HCM attending St Vincent's University Hospital and Blackrock Clinic, Dublin, were identified. Detailed review of medical notes, Holter monitor, echocardiogram, cardiac MRI (CMR) and implantable cardioverter-defibrillator (ICD) records was performed.Prevalence of AF was 38.4%. HCM patients with AF (HCM-AF) were older (60.6±14.8 v 54.9±17.3 years, P=0.016) and more symptomatic (NYHA II: 29.7% v 16.9%, NYHA III: 4.3% v 1.2%) than HCM patients without AF. History of stroke was recorded in 16.4% of HCM-AF patients, compared with 1% in those without AF.HCM-AF patients had lower left ventricular ejection fraction (echo: 59.5±11.8v68±8, P<0.001; CMR: 62.3%v70.5%, P<0.01) and higher left atrial diameter (echo: 49.8±9.5v40.9±7.4, p<0.001; CMR 62.3±11.3v70.4±9, p<0.001), compared with those without AF. Myocardial fibrosis was detected on CMR in 74% of HCM-AF patients and 62% of those without AF.34% of patients had an ICD in situ, of whom 61% had AF. 24% of these HCM-AF patients received inappropriate shocks, all triggered by AF. CONCLUSION: AF is common in the Irish HCM population. It is associated with increased risk of stroke, deterioration in symptom status and is a common trigger for inappropriate ICD discharge. We have shown, in-keeping with previous studies, that AF is associated with reduced EF, increased LA diameter and mitral regurgitation in this HCM population.
AIMS: Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with hypertrophic cardiomyopathy (HCM), and is associated with deterioration in clinical status and outcome. To date, no data have been published pertaining to AF in an Irish HCM population. METHODS AND RESULTS: 159 patients with HCM attending St Vincent's University Hospital and Blackrock Clinic, Dublin, were identified. Detailed review of medical notes, Holter monitor, echocardiogram, cardiac MRI (CMR) and implantable cardioverter-defibrillator (ICD) records was performed.Prevalence of AF was 38.4%. HCM patients with AF (HCM-AF) were older (60.6±14.8 v 54.9±17.3 years, P=0.016) and more symptomatic (NYHA II: 29.7% v 16.9%, NYHA III: 4.3% v 1.2%) than HCM patients without AF. History of stroke was recorded in 16.4% of HCM-AF patients, compared with 1% in those without AF.HCM-AF patients had lower left ventricular ejection fraction (echo: 59.5±11.8v68±8, P<0.001; CMR: 62.3%v70.5%, P<0.01) and higher left atrial diameter (echo: 49.8±9.5v40.9±7.4, p<0.001; CMR 62.3±11.3v70.4±9, p<0.001), compared with those without AF. Myocardial fibrosis was detected on CMR in 74% of HCM-AF patients and 62% of those without AF.34% of patients had an ICD in situ, of whom 61% had AF. 24% of these HCM-AF patients received inappropriate shocks, all triggered by AF. CONCLUSION: AF is common in the Irish HCM population. It is associated with increased risk of stroke, deterioration in symptom status and is a common trigger for inappropriate ICD discharge. We have shown, in-keeping with previous studies, that AF is associated with reduced EF, increased LA diameter and mitral regurgitation in this HCM population.
Entities:
Keywords:
Atrial fibrillation; Cardiac MRI; Hypertrophic Cardiomyopathy; Left Atrium
Authors: Rory O'Hanlon; Agata Grasso; Michael Roughton; James C Moon; Susan Clark; Ricardo Wage; Jessica Webb; Meghana Kulkarni; Dana Dawson; Leena Sulaibeekh; Badri Chandrasekaran; Chiara Bucciarelli-Ducci; Ferdinando Pasquale; Martin R Cowie; William J McKenna; Mary N Sheppard; Perry M Elliott; Dudley J Pennell; Sanjay K Prasad Journal: J Am Coll Cardiol Date: 2010-06-25 Impact factor: 24.094
Authors: B J Maron; I Olivotto; P Spirito; S A Casey; P Bellone; T E Gohman; K J Graham; D A Burton; F Cecchi Journal: Circulation Date: 2000-08-22 Impact factor: 29.690
Authors: Perry M Elliott; Aris Anastasakis; Michael A Borger; Martin Borggrefe; Franco Cecchi; Philippe Charron; Albert Alain Hagege; Antoine Lafont; Giuseppe Limongelli; Heiko Mahrholdt; William J McKenna; Jens Mogensen; Petros Nihoyannopoulos; Stefano Nistri; Petronella G Pieper; Burkert Pieske; Claudio Rapezzi; Frans H Rutten; Christoph Tillmanns; Hugh Watkins Journal: Eur Heart J Date: 2014-08-29 Impact factor: 29.983
Authors: S Pujadas; R Vidal-Perez; A Hidalgo; R Leta; F Carreras; A Barros; A Bayes-Genis; M T Subirana; Guillem Pons-Llado Journal: Eur J Radiol Date: 2010-01-15 Impact factor: 3.528