Long-Term Outcome of Catheter Ablation for Atrial Fibrillation in Patients With Apical Hypertrophic Cardiomyopathy

Seung Young Roh, Dong Hyeok Kim, Jinhee Ahn, Kwang No Lee, Dae In Lee, Jaemin Shim, Jongil Choi, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Atrial fibrillation (AF) is a common manifestation in cases of hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) for AF in patients with asymmetric septal HCM (SeHCM) is selectively effective and often needs a repeat procedure. Apical HCM (ApHCM) has a better prognosis than SeHCM. However, the outcome of CA for AF in patients with ApHCM is unclear. Methods and results: Eighteen patients with ApHCM (ApHCM group) and 13 SeHCM patients (SeHCM group) underwent CA for AF. Ninety sex-, age-, and AF type-matched non-HCM patients who underwent CA for AF were selected as controls (5 controls for each ApHCM patient). During a median follow-up of 44.7 ± 30.8 months, 50% of the patients remained free from AF/atrial tachycardia (AT) in the ApHCM group. The ApHCM patients displayed enlarged left atrial (LA) diameter (47.1 ± 6.0 mm vs. 42.4 ± 5.5 mm, P = 0.006) and increased E/Ea ratio (13.5 ± 4.4 vs. 9.1 ± 3.1, P < 0.001) as compared to the control group. In contrast, the mean LA diameter and E/Ea ratio of the ApHCM group were not different than those of the SeHCM group. The overall freedom from AF/AT in the ApHCM group was significantly worse than in the control group (log rank P = 0.028), but there was no difference between the ApHCM and SeHCM groups (P = 0.831). High LA diameter index ≥25 mm/m2 (HR 12.8, 95% CI [1.2–142.1]; P = 0.037) was an independent predictor of AF/AT recurrence among patients with ApHCM. Conclusion: Long-term outcome of CA for AF was worse in patients with ApHCM, as compared to controls, but was similar to patients with SeHCM.

Original languageEnglish
Pages (from-to)788-795
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume27
Issue number7
DOIs
Publication statusPublished - 2016 Jul 1

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Catheter Ablation
Hypertrophic Cardiomyopathy
Atrial Fibrillation
Tachycardia
Control Groups
Cardiomyopathies

Keywords

  • apical hypertrophic cardiomyopathy
  • atrial fibrillation
  • catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Long-Term Outcome of Catheter Ablation for Atrial Fibrillation in Patients With Apical Hypertrophic Cardiomyopathy. / Roh, Seung Young; Kim, Dong Hyeok; Ahn, Jinhee; Lee, Kwang No; Lee, Dae In; Shim, Jaemin; Choi, Jongil; Park, Sang Weon; Kim, Young Hoon.

In: Journal of Cardiovascular Electrophysiology, Vol. 27, No. 7, 01.07.2016, p. 788-795.

Research output: Contribution to journalArticle

Roh, Seung Young ; Kim, Dong Hyeok ; Ahn, Jinhee ; Lee, Kwang No ; Lee, Dae In ; Shim, Jaemin ; Choi, Jongil ; Park, Sang Weon ; Kim, Young Hoon. / Long-Term Outcome of Catheter Ablation for Atrial Fibrillation in Patients With Apical Hypertrophic Cardiomyopathy. In: Journal of Cardiovascular Electrophysiology. 2016 ; Vol. 27, No. 7. pp. 788-795.
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abstract = "Introduction: Atrial fibrillation (AF) is a common manifestation in cases of hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) for AF in patients with asymmetric septal HCM (SeHCM) is selectively effective and often needs a repeat procedure. Apical HCM (ApHCM) has a better prognosis than SeHCM. However, the outcome of CA for AF in patients with ApHCM is unclear. Methods and results: Eighteen patients with ApHCM (ApHCM group) and 13 SeHCM patients (SeHCM group) underwent CA for AF. Ninety sex-, age-, and AF type-matched non-HCM patients who underwent CA for AF were selected as controls (5 controls for each ApHCM patient). During a median follow-up of 44.7 ± 30.8 months, 50{\%} of the patients remained free from AF/atrial tachycardia (AT) in the ApHCM group. The ApHCM patients displayed enlarged left atrial (LA) diameter (47.1 ± 6.0 mm vs. 42.4 ± 5.5 mm, P = 0.006) and increased E/Ea ratio (13.5 ± 4.4 vs. 9.1 ± 3.1, P < 0.001) as compared to the control group. In contrast, the mean LA diameter and E/Ea ratio of the ApHCM group were not different than those of the SeHCM group. The overall freedom from AF/AT in the ApHCM group was significantly worse than in the control group (log rank P = 0.028), but there was no difference between the ApHCM and SeHCM groups (P = 0.831). High LA diameter index ≥25 mm/m2 (HR 12.8, 95{\%} CI [1.2–142.1]; P = 0.037) was an independent predictor of AF/AT recurrence among patients with ApHCM. Conclusion: Long-term outcome of CA for AF was worse in patients with ApHCM, as compared to controls, but was similar to patients with SeHCM.",
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T1 - Long-Term Outcome of Catheter Ablation for Atrial Fibrillation in Patients With Apical Hypertrophic Cardiomyopathy

AU - Roh, Seung Young

AU - Kim, Dong Hyeok

AU - Ahn, Jinhee

AU - Lee, Kwang No

AU - Lee, Dae In

AU - Shim, Jaemin

AU - Choi, Jongil

AU - Park, Sang Weon

AU - Kim, Young Hoon

PY - 2016/7/1

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N2 - Introduction: Atrial fibrillation (AF) is a common manifestation in cases of hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) for AF in patients with asymmetric septal HCM (SeHCM) is selectively effective and often needs a repeat procedure. Apical HCM (ApHCM) has a better prognosis than SeHCM. However, the outcome of CA for AF in patients with ApHCM is unclear. Methods and results: Eighteen patients with ApHCM (ApHCM group) and 13 SeHCM patients (SeHCM group) underwent CA for AF. Ninety sex-, age-, and AF type-matched non-HCM patients who underwent CA for AF were selected as controls (5 controls for each ApHCM patient). During a median follow-up of 44.7 ± 30.8 months, 50% of the patients remained free from AF/atrial tachycardia (AT) in the ApHCM group. The ApHCM patients displayed enlarged left atrial (LA) diameter (47.1 ± 6.0 mm vs. 42.4 ± 5.5 mm, P = 0.006) and increased E/Ea ratio (13.5 ± 4.4 vs. 9.1 ± 3.1, P < 0.001) as compared to the control group. In contrast, the mean LA diameter and E/Ea ratio of the ApHCM group were not different than those of the SeHCM group. The overall freedom from AF/AT in the ApHCM group was significantly worse than in the control group (log rank P = 0.028), but there was no difference between the ApHCM and SeHCM groups (P = 0.831). High LA diameter index ≥25 mm/m2 (HR 12.8, 95% CI [1.2–142.1]; P = 0.037) was an independent predictor of AF/AT recurrence among patients with ApHCM. Conclusion: Long-term outcome of CA for AF was worse in patients with ApHCM, as compared to controls, but was similar to patients with SeHCM.

AB - Introduction: Atrial fibrillation (AF) is a common manifestation in cases of hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) for AF in patients with asymmetric septal HCM (SeHCM) is selectively effective and often needs a repeat procedure. Apical HCM (ApHCM) has a better prognosis than SeHCM. However, the outcome of CA for AF in patients with ApHCM is unclear. Methods and results: Eighteen patients with ApHCM (ApHCM group) and 13 SeHCM patients (SeHCM group) underwent CA for AF. Ninety sex-, age-, and AF type-matched non-HCM patients who underwent CA for AF were selected as controls (5 controls for each ApHCM patient). During a median follow-up of 44.7 ± 30.8 months, 50% of the patients remained free from AF/atrial tachycardia (AT) in the ApHCM group. The ApHCM patients displayed enlarged left atrial (LA) diameter (47.1 ± 6.0 mm vs. 42.4 ± 5.5 mm, P = 0.006) and increased E/Ea ratio (13.5 ± 4.4 vs. 9.1 ± 3.1, P < 0.001) as compared to the control group. In contrast, the mean LA diameter and E/Ea ratio of the ApHCM group were not different than those of the SeHCM group. The overall freedom from AF/AT in the ApHCM group was significantly worse than in the control group (log rank P = 0.028), but there was no difference between the ApHCM and SeHCM groups (P = 0.831). High LA diameter index ≥25 mm/m2 (HR 12.8, 95% CI [1.2–142.1]; P = 0.037) was an independent predictor of AF/AT recurrence among patients with ApHCM. Conclusion: Long-term outcome of CA for AF was worse in patients with ApHCM, as compared to controls, but was similar to patients with SeHCM.

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