Long‐term outcome of catheter ablation for atrial fibrillation in patients with apical hypertrophic cardiomyopathy

• Published in: Journal of cardiovascular electrophysiology Vol. 29; no. 7; pp. 951 - 957
• Main Authors: Chen, Xuan, Dong, Jian‐Zeng, Du, Xin, Wu, Jia‐Hui, Yu, Rong‐Hui, Long, De‐Yong, Ning, Man, Sang, Cai‐Hua, Jiang, Chen‐Xi, Bai, Rong, Wen, Song‐Nan, Liu, Nian, Li, Song‐Nan, Xu, Zhi‐Yuan, Ma, Chang‐Sheng, Tang, Ri‐Bo
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2018
• Subjects: apical hypertrophic cardiomyopathy; atrial fibrillation; atrial flutter; Cardiomyopathy; catheter ablation; Catheters; Fibrillation; Radiofrequency ablation; stroke; Success; Thromboembolism; atrial fibrillation; catheter ablation; apical hypertrophic cardiomyopathy; stroke; atrial flutter
• ISSN: 1045-3873; 1540-8167; 1540-8167
• DOI: 10.1111/jce.13645

Introduction To assess the long‐term outcome of catheter ablation in patients with hypertrophic cardiomyopathy (HCM), especially in patients with apical HCM (ApHCM). Methods and results From 9,249 AF ablation cases, 97 patients (28 with ApHCM and 69 with non‐ApHCM) were enrolled. Another 97 patients matched by age, AF type, AF duration, and left atrial diameter were selected as the control group. After a mean follow‐up of (44.3 ± 29.6) months, success rate after a single procedure was 42.9% in the ApHCM patients (P  =  0.725), 36.2% in the non‐ApHCM patients (P  =  0.136) versus 50.5% in the control group. After multiple procedures, success rate both in the ApHCM group (50%, P  =  0.047) and in the non‐ApHCM group (50.4%, P  =  0.017) were lower than in the controls (68.0%). More patients in the ApHCM and in the non‐ApHCM group suffered very late recurrence beyond 1 year after the index procedure. Left atrial diameter (hazard ratio [HR] 1.04, 95% confidential interval [CI] 1.01–1.08, P  =  0.018) and AF duration (HR 1.01, 95% CI 1.00–1.01, P  =  0.005) were independent predictors of recurrence after the index ablation. There was no difference in thromboembolic events between the HCM group and the control group (8.2% vs. 3.1%, P  =  0.082). Conclusions Patients with ApHCM or non‐ApHCM had similar success rate of AF ablation after single procedure and lower success rate after multiple procedure compared with the control group.