Impact of atrial fibrillation on the clinical course of apical hypertrophic cardiomyopathy

Sang Eun Lee, Jin Kyu Park, Jae Sun Uhm, Jong Youn Kim, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background Apical hypertrophic cardiomyopathy (ApHCM) is considered a 'benign' form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM. Methods The occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years). Results AF occurred in 77 patients with ApHCM (prevalence, 25.2%; annual incidence, 4.6%/year) and was independently predicted by old age and large left atrium (>45 mm). Among 70 AF patients indicated with anticoagulation, 53 patients (76%) received warfarin. During a follow-up of 5.5±2.0 years, the patients with AF had a higher incidence of all-cause death, cardiovascular death and strokes (11.7% vs 1.3%, 6.5% vs 0.9% and 19.5% vs 2.6%, respectively, all p<0.05) than those without AF. When adjusted by the age and gender, those with AF still had an increased risk for allcause death (HR 6.58; 95% CI 1.65-26.16, p=0.007) and strokes (HR 5.13; 95% CI 1.85 to 14.18, p=0.002). AF was detected before the time of stroke in 8 (53%) out of 15 patients with both AF and stroke. In addition, six out of eight patients were on anticoagulation at the time of stroke. The cause of death was a stroke in three (33%) out of nine patients with AF. Conclusion In patients with ApHCM, AF was common and was associated with a substantial risk for strokes and mortality suggesting that AF should be carefully managed in ApHCM.

Original languageEnglish
Pages (from-to)1496-1501
Number of pages6
JournalHeart
Volume103
Issue number19
DOIs
Publication statusPublished - 2017 Oct

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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