Prevalence and Impact of Atrial Fibrillation in a Cohort of Patients with Hypertrophic Cardiomyopathy in Ireland

Overview

Journal J Atr Fibrillation

Date 2021 Dec 24

PMID 34950304

Citations 1

Authors

McClelland S

OConnor Sa

Donohue S

Lavelle L

McErlean A

Dodd Jd

Meaney J

McCreery Cj

McDonald K

Quinn M

Erwin Je

Quigley Pj

Maurer B

Keane D

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Characterization of atrial histology in a patient with hypertrophic cardiomyopathy: Possible evidence of a primary atrial myopathy.

Keane S, Fabre A, Keane D HeartRhythm Case Rep. 2021; 7(6):413-417.

PMID: 34194992 PMC: 8226312. DOI: 10.1016/j.hrcr.2021.03.017.

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