Incidence and Outcomes of Atrial Fibrillation and Systolic Dysfunction in Patients Receiving Mavacamten for Obstructive Hypertrophic Cardiomyopathy: A Multicenter Study

Olives Nguyen; Jack Wiedrick; Daniele Massera; Elizabeth Adlestein; Sumar Frejat; M Castrichini; Said Alsidawi; John Giudicessi; J. Geske; Richard T. Carrick; José Madrazo; Nicole Dellise; Mark A. Zenker; Thomas A. Boyle; N Reza; A. Owens; David S. Frankel; Prabhjot Hundal; Jamil Tajik; Patrycja Galazka; Myra Lewontin; Michael Ayers; Timothy C. Wong; M. Casey Flanagan; Sumeet S. Mitter; Arjun Kanwal; Ozlem Bilen; Sarah Baghdadi; Hirak Shah; Jared Kvapil; Paola Roldan; Loren Berenbom; Jill T. Jesurum; Denise Tootill; Alice Siqueira-Benzow; Mariko W. Harper; Danish Saleh; M. Lang; Dermot Phelan; Dmitry Prizand; Neal Lakdawala; C Y Ho; Lusha W. Liang; Shepard D. Weiner; Sririam Ravi; Ahmed Abuzaid; Mohammed Makkiya; Jeremy Markowitz; Mark V. Sherrid; Ahmad Munir Masri

doi:10.1016/j.cardfail.2026.02.035

March 1, 2026Journal of Cardiac FailureOpen Access

Incidence and Outcomes of Atrial Fibrillation and Systolic Dysfunction in Patients Receiving Mavacamten for Obstructive Hypertrophic Cardiomyopathy: A Multicenter Study

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Key Points

To evaluate the real-world incidence and clinical outcomes of atrial fibrillation and left ventricular systolic dysfunction among patients receiving mavacamten for obstructive hypertrophic cardiomyopathy.
Conducted an observational analysis of center-level data across 21 hypertrophic cardiomyopathy centers in the United States.
Included 1,538 patients with obstructive hypertrophic cardiomyopathy prescribed commercial mavacamten (median dose 5 mg [95% CI, 5–5] over a median follow-up of 13.4 [95% CI, 11.8, 15.0] months), excluding individuals with permanent atrial fibrillation.
New-onset atrial fibrillation developed in 60 patients (5% [95% CI, 4–7%]), paroxysmal atrial fibrillation recurred in 146 patients (39% [95% CI, 27–51%]), and the overall rate of atrial fibrillation was 13% [95% CI, 10–17%].
Left ventricular ejection fraction <50% occurred in 116 patients (8% [95% CI, 6–9%]), with 79 of these patients (70% [95% CI, 45–96%]) exhibiting concurrent atrial fibrillation, and symptomatic heart failure occurring in 24 patients (21% [95% CI, 11–31%]).
Severe adverse events included cardiogenic shock in 7 patients (0.6% [95% CI, 0.1–1%]), hospitalizations in 110 patients (7% [95% CI, 3–10%]), and death in 5 patients (0.32% [95% CI, 0.02–0.6%]).

Structured PICO

P

Population

1,538 patients with obstructive hypertrophic cardiomyopathy (oHCM) who were prescribed commercial mavacamten across 21 HCM centers in the United States, median age 66, 57% female. Permanent AF excluded.

I

Intervention

Mavacamten (median dose 5 mg) over a median of 13.4 months

O

Outcome

Incidence of new-onset and recurrent atrial fibrillation (AF) and left ventricular systolic dysfunction (LVEF <50%) over a median of 13.4 monthssafety

Limitations

Absence of a control group of comparable oHCM patients not treated with mavacamten
Retrospective design precluded standardized AF surveillance
Collected center-level data with a focus on safety, lacking detailed patient characteristics and efficacy outcomes
Relatively short median follow-up

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Implication

In a real-world multi-center cohort of patients with oHCM on commercial mavacamten, incidence of new-onset AF was 5% and LVEF <50% was 8%, highlighting a strong concurrency between AF events and significant LVEF reduction.

Abstract

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Cite This Study

Nguyen et al. (2026) studied this question.

synapsesocial.com/papers/6a025ca6edf6f4813859483c https://doi.org/10.1016/j.cardfail.2026.02.035

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Incidence and Outcomes of Atrial Fibrillation and Systolic Dysfunction in Patients Receiving Mavacamten for Obstructive Hypertrophic Cardiomyopathy: A Multicenter Study

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Incidence and Outcomes of Atrial Fibrillation and Systolic Dysfunction in Patients Receiving Mavacamten for Obstructive Hypertrophic Cardiomyopathy: A Multicenter Study

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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