Usefulness and safety of transcatheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy
Abstract
Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HC) and predicts adverse outcome. Radiofrequency catheter ablation (RFCA) represents a potentially advantageous alternative to lifelong pharmacologic treatment. However, its efficacy in patients with HC is not established. In the present study, the feasibility, safety, and efficacy of RFCA of AF in patients with HC were evaluated. Twenty-six patients with HC with paroxysmal (n = 13) or permanent (n = 13) AF refractory to antiarrhythmic therapy (age 58 +/- 11 years, time from AF onset 7.3 +/- 6.2 years, left atrial volume 170 +/- 48 ml) underwent RFCA. A schema with pulmonary vein isolation plus linear lesions was used. No major periprocedural complication occurred. One patient died from a hemorrhagic stroke 4 weeks after RFCA while in sinus rhythm. During a 19 +/- 10-month follow-up, 9 of the remaining 25 patients (36%) experienced recurrence of AF (despite repeated RFCA in 3) and were considered failures, whereas 16 remained in sinus rhythm (i.e., 64% overall success rate). Ten of these 16 patients were off antiarrhythmic drug therapy at final evaluation. RFCA was highly successful in patients with paroxysmal AF (77% success rate compared with 50% in the subgroup with permanent AF). Patients with restoration of sinus rhythm showed marked symptomatic improvement (final New York Heart Association functional class 1.2 +/- 0.5 vs 1.7 +/- 0.7 before the procedure, p = 0.003). Conversely, patients for whom RFCA failed showed no change (final functional class 1.9 +/- 0.8 vs 1.7 +/- 0.9 before the procedure, p = 0.59). In conclusion, in most studied patients with HC, RFCA proved a safe and effective therapeutic option for AF, improved functional status, and was able to reduce or postpone the need for long-term pharmacologic treatment.
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AF ablation is effective to suppress symptomatic AF recurrences in hypertrophic cardiomyopathy.
“AF ablation is effective to suppress symptomatic AF recurrences.[880][881][882][883][884]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [882]
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- Authors
- Gaita, F., Di Donna, P., Olivotto, I., Scaglione, M., Ferrero, I., Montefusco, A., Caponi, D., Conte, M. R., Nistri, S., & Cecchi, F.
- Affiliations
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Azienda Sanitaria Locale di Asti (IT)
- Ospedale degli Infermi (IT)
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 99
- Issue
- 11
- Pages
- 1575-1581
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2166808786
- Cited by
- 91
- References
- 27
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 7 · 2014: 11 · 2013: 8 · 2012: 5
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atrial fibrillation, hypertrophic cardiomyopathy, radiofrequency catheter ablation, pulmonary vein isolation, paroxysmal atrial fibrillation, permanent atrial fibrillation, antiarrhythmic drug withdrawal, sinus rhythm restoration, procedural safety, arrhythmia recurrence, NYHA functional class
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anti-Arrhythmia Agents, Atrial Fibrillation, Cardiomyopathy, Hypertrophic, Equipment Safety, Feasibility Studies, Female, Follow-Up Studies, Heart Conduction System, Humans, Italy, Male, Middle Aged, Predictive Value of Tests, Echocardiography, Doppler, Electrocardiography, Ambulatory, Survival Analysis, Atrial Function, Treatment Outcome, Catheter Ablation
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