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Article Abstract
Background: The prognostic impact of catheter ablation (CA) of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients has not yet been satisfactorily elucidated.
Objectives: The aim of the study was to assess the impact of CA of AF on clinical outcomes in a large cohort of HCM patients.
Methods: In this retrospective multicenter study, 555 HCM patients with AF were enrolled, 140 undergoing CA and 415 receiving medical therapy. 1:1 propensity score matching led to the inclusion of 226 patients (113 medical group, 113 intervention group) in the final analysis. The primary outcome was a composite of all-cause mortality, heart transplant and acute heart failure exacerbations. Secondary outcomes included AF recurrence and transition to permanent AF. Additionally, an inverse probability weighted (IPW) model was examined.
Results: At propensity score matching analysis, after a median follow-up of 58.1 months, the primary endpoint occurred in 29 (25.7%) patients in intervention group vs 42 (37.2%) in medical group ( = 0.9). Thromboembolic strokes and major arrhythmic events in intervention vs medical group were 9.7% vs 7.1% ( = 0.144) and 4.4 vs 8.0% ( = 0.779), respectively. Fewer patients in intervention vs medical group experienced AF recurrences (63.7% vs 84.1%, = 0.001) and transition to permanent AF pattern (20.4% vs 33.6%, = 0.026). IPW analysis showed consistent results. Severe complications related to CA were uncommon (0.7%).
Conclusions: After 5 years of follow-up, CA did not improve major adverse cardiac outcomes in a large cohort of patients with HCM and AF. Nevertheless, CA seems to facilitate the maintenance of sinus rhythm and slow the progression to permanent AF, without significant safety concerns.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198158 | PMC |
| http://dx.doi.org/10.1016/j.jacadv.2024.100899 | DOI Listing |
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