Predictive value of sudden cardiac death risk stratification for outcomes of catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy

• Published in: Heart rhythm
• Main Authors: Du, Zhuo-Hang, Wang, Wei, Zhao, Xin, Li, Chang-Yi, Yu, Rong-Hui, Liu, Nian, Li, Song-Nan, Liu, Xiao-Xia, Guo, Xue-Yuan, Zuo, Song, Li, Meng-Meng, Liu, Tong, Dai, Wen-Li, Huang, Li-Hong, Guo, Qi, Gao, Ming-Yang, Lv, Wen-He, Li, Yu-Kun, Wang, Xue-Si, Li, Jia-Lin, Liu, Xiao-Ying, Li, Xin-Ru, Jiang, Chen-Xi, Sang, Cai-Hua, Long, De-Yong, Dong, Jian-Zeng, Ma, Chang-Sheng, Tang, Ri-Bo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 22.07.2025
• Subjects: Atrial fibrillation; Catheter ablation; Hypertrophic cardiomyopathy; Recurrence; Sudden cardiac death; Recurrence; ApHCM; AF; Atrial fibrillation; Catheter ablation; LR; ECG; M-HR; ICD; Sudden cardiac death; HCM; SCD; Hypertrophic cardiomyopathy; CA
• ISSN: 1547-5271; 1556-3871; 1556-3871
• DOI: 10.1016/j.hrthm.2025.07.027

Prediction models for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) incorporate factors that influence outcomes of catheter ablation (CA) of atrial fibrillation (AF). This study aimed to investigate the outcomes of CA of AF in patients with HCM stratified by SCD risk. Of the 23,904 patients who underwent CA of AF, 417 patients with HCM were screened. After excluding ineligible patients, 339 patients were ultimately included in the study. Participants were classified into a low-risk (LR) group (n = 292) and a medium- to high-risk (M-HR) group (n = 47) according to the HCM risk-SCD model. Long-term outcomes were compared between the groups. After a median follow-up of 43.0 months (12.0–69.0), recurrence rate after a single procedure was significantly higher in the M-HR group than in the LR group (70.2% vs 41.8%, P < .001). After the last ablation, the recurrence rate was also higher in the M-HR group than in the LR group (57.4% vs 32.2%, P < .001). In multivariate analysis, M-HR of SCD was an independent predictor of recurrence(hazard ratio 1.77, 95% confidence interval 1.14–2.74, P = .010). During follow-up, no significant differences were observed in cardiac death (2.1% vs 2.1%, P = .995), heart failure hospitalization (8.5% vs 5.1%, P = .471), or stroke (10.6% vs 3.8%, P = .071). M-HR of SCD in HCM was associated with a higher recurrence rate after CA of AF.