Atrial Fibrillation in Hypertrophic Cardiomyopathy

Heart Lung Circ. 2017 Sep;26(9):975-982. doi: 10.1016/j.hlc.2017.05.116. Epub 2017 May 23.

Abstract

Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disorder with a spectrum of clinical manifestations. Patients with HCM are predisposed to developing atrial fibrillation (AF) due primarily to advanced diastolic dysfunction and left atrial (LA) dilatation and remodelling. Atrial fibrillation causes a progressive symptomatic and functional decline, as well as increased thromboembolic risk and mortality, particularly in the setting of rapid ventricular rates and left ventricular outflow tract (LVOT) obstruction. The mainstay of management of AF in HCM is a combination of non-pharmacological lifestyle and risk factor modification, long-term anticoagulation, and rhythm control with antiarrhythmic medications. There is a growing body of evidence indicating that an early and aggressive rhythm control strategy may result in more favourable outcomes.

Keywords: Anti-arrhythmia agents; Atrial fibrillation; Catheter ablation; Hypertrophic cardiomyopathy.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / etiology
  • Atrial Fibrillation* / therapy
  • Cardiomyopathy, Hypertrophic* / complications
  • Cardiomyopathy, Hypertrophic* / epidemiology
  • Cardiomyopathy, Hypertrophic* / therapy
  • Catheter Ablation / methods*
  • Global Health
  • Heart Ventricles / physiopathology*
  • Humans
  • Incidence
  • Risk Factors
  • Survival Rate / trends

Substances

  • Anti-Arrhythmia Agents