Transcatheter Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: A Multicenter Propensity Score-Based Analysis.
atrial fibrillation
catheter ablation
hypertrophic cardiomyopathy
propensity score matching
Journal
JACC. Advances
ISSN: 2772-963X
Titre abrégé: JACC Adv
Pays: United States
ID NLM: 9918419284106676
Informations de publication
Date de publication:
May 2024
May 2024
Historique:
received:
31
08
2023
revised:
09
01
2024
accepted:
05
02
2024
medline:
28
6
2024
pubmed:
28
6
2024
entrez:
28
6
2024
Statut:
epublish
Résumé
The prognostic impact of catheter ablation (CA) of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients has not yet been satisfactorily elucidated. The aim of the study was to assess the impact of CA of AF on clinical outcomes in a large cohort of HCM patients. In this retrospective multicenter study, 555 HCM patients with AF were enrolled, 140 undergoing CA and 415 receiving medical therapy. 1:1 propensity score matching led to the inclusion of 226 patients (113 medical group, 113 intervention group) in the final analysis. The primary outcome was a composite of all-cause mortality, heart transplant and acute heart failure exacerbations. Secondary outcomes included AF recurrence and transition to permanent AF. Additionally, an inverse probability weighted (IPW) model was examined. At propensity score matching analysis, after a median follow-up of 58.1 months, the primary endpoint occurred in 29 (25.7%) patients in intervention group vs 42 (37.2%) in medical group ( After 5 years of follow-up, CA did not improve major adverse cardiac outcomes in a large cohort of patients with HCM and AF. Nevertheless, CA seems to facilitate the maintenance of sinus rhythm and slow the progression to permanent AF, without significant safety concerns.
Sections du résumé
Background
UNASSIGNED
The prognostic impact of catheter ablation (CA) of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients has not yet been satisfactorily elucidated.
Objectives
UNASSIGNED
The aim of the study was to assess the impact of CA of AF on clinical outcomes in a large cohort of HCM patients.
Methods
UNASSIGNED
In this retrospective multicenter study, 555 HCM patients with AF were enrolled, 140 undergoing CA and 415 receiving medical therapy. 1:1 propensity score matching led to the inclusion of 226 patients (113 medical group, 113 intervention group) in the final analysis. The primary outcome was a composite of all-cause mortality, heart transplant and acute heart failure exacerbations. Secondary outcomes included AF recurrence and transition to permanent AF. Additionally, an inverse probability weighted (IPW) model was examined.
Results
UNASSIGNED
At propensity score matching analysis, after a median follow-up of 58.1 months, the primary endpoint occurred in 29 (25.7%) patients in intervention group vs 42 (37.2%) in medical group (
Conclusions
UNASSIGNED
After 5 years of follow-up, CA did not improve major adverse cardiac outcomes in a large cohort of patients with HCM and AF. Nevertheless, CA seems to facilitate the maintenance of sinus rhythm and slow the progression to permanent AF, without significant safety concerns.
Identifiants
pubmed: 38939638
doi: 10.1016/j.jacadv.2024.100899
pii: S2772-963X(24)00077-2
pmc: PMC11198158
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100899Informations de copyright
© 2024 The Authors.
Déclaration de conflit d'intérêts
Prof Olivotto has received research grants from: BMS-Myokardia, Cytokinetics, Boston Scientific, Amicus, Sanofi Genzyme, Shire Takeda, Menarini International, Bayer, and Chiesi, Tenaya; and is on the advisory board for BMS-Myokardia, Cytokinetics, Amicus, Sanofi Genzyme, Chiesi, Tenaya, and Rocket Pharma. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.