What is the clinical evidence from this study?

Study design: Systematic Review. Population: Hypertrophic Cardiomyopathy and Atrial Fibrillation (n=579). Intervention: Catheter ablation vs. Pharmacological treatment. Primary outcome: Combined adverse events (mortality, stroke, and heart failure) (OR 0.22, 95% CI 0.08 to 0.60, p=< 0.05).

What does this research mean for the field?

Catheter ablation significantly reduces the composite risk of adverse clinical events and heart failure hospitalizations compared to medical therapy in patients with hypertrophic cardiomyopathy and atrial fibrillation. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2026International Journal of Cardiovascular SciencesOpen Access

Long-Term Clinical Outcomes of Catheter Ablation in Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Systematic Review and Meta-Analysis

Q: What are the key findings of this study?

Catheter ablation significantly reduced the composite risk of mortality, stroke, and heart failure (OR 0.22) compared to pharmacological treatment in patients with hypertrophic cardiomyopathy and atrial fibrillation.

Q: What does this research mean for the field?

Catheter ablation significantly reduces the composite risk of adverse clinical events and heart failure hospitalizations compared to medical therapy in patients with hypertrophic cardiomyopathy and atrial fibrillation. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Catheter ablation cuts major composite events ~78% vs. drugs in HCM with AF.

OR 0.22
95% CI 0.08 to 0.60
P<0.05
n=579

Why the study?

Patients with HCM are at increased risk of AF, but the benefits of catheter ablation for reducing adverse clinical outcomes in this population remain not well established.

Does catheter ablation reduce adverse clinical outcomes in patients with hypertrophic cardiomyopathy and atrial fibrillation compared to pharmacological treatment?

Study Design

Type

Systematic Review (n=579)

Structured PICO

Does catheter ablation reduce adverse clinical outcomes in patients with hypertrophic cardiomyopathy and atrial fibrillation compared to pharmacological treatment?

Population

579 patients with hypertrophic cardiomyopathy and atrial fibrillation from four retrospective cohort studies, followed for a mean of 5.5 years to assess the impact of catheter ablation versus pharmacological therapy.

Intervention

Catheter ablation (CA) for atrial fibrillation

Comparator

Pharmacological treatment (antiarrhythmic and anticoagulation therapy regimens)

Outcome

Composite adverse event rate (mortality, heart failure hospitalization, and stroke incidence)composite

Main Result

Odds Ratio: 0.22 (95% CI 0.08–0.6)

Absolute Event Rate: 18.35% vs 42.51%

p-value: p=< 0.05

In patients with hypertrophic cardiomyopathy and atrial fibrillation, catheter ablation is associated with a significant reduction in heart failure hospitalizations and composite adverse events compared to medical therapy.

Limitations

Only four controlled observational studies were identified, limiting statistical power and generalizability.
Heterogeneity in study design, ablation techniques, follow-up duration, and concomitant therapies.
Small sample sizes and geographic concentration of included cohorts.
Retrospective design of all included studies introduces inherent biases.
Publication bias cannot be excluded because a funnel plot could not be performed.
Only four controlled observational studies were identified, limiting statistical power and generalizability
Heterogeneity in study design, ablation techniques, follow-up duration, and concomitant therapies
Small sample sizes and geographic concentration of included cohorts
Inability to perform subgroup analysis or funnel plot due to small number of studies
Retrospective design of all included studies introduces inherent biases

Implication

Hypothesis-generating for ablation over drugs in HCM-AF; leaves open RCTs before changing practice.

Abstract

Background: Patients with hypertrophic cardiomyopathy (HCM) are at increased risk of atrial fibrillation (AF). However, the benefits of catheter ablation (CA) for reducing adverse clinical outcomes in this population are not well established. Objective: To assess the long-term impact of CA on clinical outcomes in patients with HCM and AF through a systematic review and meta-analysis. Methods: Controlled studies of patients with HCM and AF undergoing CA were identified through PubMed/MEDLINE, Embase, LILACS, and Cochrane. Meta-analysis employed a random-effects [...]

Discussion

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Cite This Study

Cardoso et al. (2026) conducted a systematic review in Hypertrophic Cardiomyopathy and Atrial Fibrillation (n=579). Catheter ablation vs. Pharmacological treatment was evaluated on Combined adverse events (mortality, stroke, and heart failure) (OR 0.22, 95% CI 0.08 to 0.60, p=< 0.05). Catheter ablation significantly reduced the composite risk of mortality, stroke, and heart failure (OR 0.22) compared to pharmacological treatment in patients with hypertrophic cardiomyopathy and atrial fibrillation.

synapsesocial.com/papers/6a8072c2e1341be402e478e3 https://doi.org/10.36660/ijcs.20250089

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Implication

Hypothesis-generating for ablation over drugs in HCM-AF; leaves open RCTs before changing practice.

Long-Term Clinical Outcomes of Catheter Ablation in Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Systematic Review and Meta-Analysis

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Long-Term Clinical Outcomes of Catheter Ablation in Hypertrophic Cardiomyopathy and Atrial Fibrillation: A Systematic Review and Meta-Analysis

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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