Key result
Catheter ablation reduces AF symptom burden in HCM and cardiac amyloidosis despite moderate recurrence.
Why the study?
AF is common in HCM and CA and leads to adverse outcomes, while medical management produces variable results and ablation offers symptomatic benefits, motivating a summary of contemporary management data.
This review highlights that catheter ablation and early rhythm control strategies may offer better symptom relief and outcomes compared to medical therapy for atrial fibrillation in patients with hypertrophic cardiomyopathy and cardiac amyloidosis.
May support early rhythm control including ablation for symptom relief in HCM and CA; leaves open need for randomized trials.
Atrial fibrillation (AF) is the most common arrhythmia in patients affected by cardiomyopathies. Reports estimate a prevalence of 27% in patients with hypertrophic cardiomyopathy (HCM) and 40% in patients with cardiac amyloidosis (CA). The presence of AF typically results in progressive functional decline, an increased frequency of hospitalizations for heart failure, and a higher thromboembolic risk. Medical management using mainly beta-blockers or amiodarone has produced variable outcomes and a high rate of recurrence. Catheter ablation reduces symptom burden and complications despite a moderate rate of recurrence. Recent evidence suggests that an early rhythm control strategy may lead to more favorable short- and long-term outcomes. In this review, we summarize contemporary data on the management of AF in patients with cardiomyopathy (HCM and CA) with particular reference to the timing and outcomes of ablation procedures.
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Mistrulli et al. (2024) conducted a review in Atrial fibrillation in hypertrophic cardiomyopathy and cardiac amyloidosis. Catheter ablation and medical management was evaluated. Atrial fibrillation has a prevalence of 27% in hypertrophic cardiomyopathy and 40% in cardiac amyloidosis, and catheter ablation reduces symptom burden despite a moderate rate of recurrence.
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