Abstract Background Catheter ablation (CA) for atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM) poses unique challenges due to structural and electrical remodeling. This study examines AF recurrence and complication rates following CA in HCM patients compared to a matched AF non-HCM cohort. Methods A retrospective cohort study of Danish nationwide registries from 2010-2022 was conducted. Rates of AF recurrence, heart failure, ischemic stroke, and death were analysed using propensity score matching and Cox regression models. Results Among 28,231 patients undergoing first time CA for AF, 299 had a confirmed diagnosis of HCM. Patients with HCM demonstrated significantly higher rates of AF recurrence compared to a matched non-HCM cohort, with 40% experiencing recurrence versus 30% in the non-HCM group after 1 year and 67% versus 58% after 5 years (hazard ratio HR 1.41, p 0.001). Despite the elevated recurrence rates, no significant differences were observed in the incidence of ischemic stroke (HR 0.99, p = 0.9) or all-cause mortality (HR 1.18, p = 0.3). However, the risk of heart failure was significantly increased (HR 2.45, p = 0.001). Conclusion HCM patients experience higher AF recurrence rates post-CA as well as a higher risk of heart failure. These findings highlight the need for tailored strategies to improve outcomes in this high-risk group.
Zörner et al. (Wed,) studied this question.