Key result
Hypertrophic cardiomyopathy was independently associated with a higher risk of atrial fibrillation recurrence after cryoballoon ablation compared to non-HCM patients (HR 2.74).
Why the study?
Data on cryoballoon ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy are relatively scarce.
Does cryoballoon ablation for pulmonary vein isolation improve freedom from atrial fibrillation in patients with hypertrophic cardiomyopathy compared to non-HCM patients?
Case-Control (n=108)
No
Does cryoballoon ablation for pulmonary vein isolation improve freedom from atrial fibrillation in patients with hypertrophic cardiomyopathy compared to non-HCM patients?
Hazard Ratio: 2.74 (95% CI 1.29–5.79)
Absolute Event Rate: 55.1% vs 77.8%
p-value: p=0.008
Cryoballoon ablation is safe and effective for treating symptomatic atrial fibrillation in patients with hypertrophic cardiomyopathy, though they have a significantly higher risk of recurrence compared to non-HCM patients.
May warrant closer monitoring after cryoballoon ablation in HCM; leaves open whether randomized trials confirm differential efficacy.
BACKGROUND: Atrial fibrillation (AF) is a generally acknowledged turning-point of the natural history of hypertrophic cardiomyopathy (HCM); however, data from the cryoballoon ablation (CBA) for AF in HCM patients are relatively scarce. The study aimed to evaluate the efficacy and safety of CBA in HCM patients with AF. METHODS: We retrospectively analyzed HCM patients among 1253 patients with symptomatic AF who underwent CBA for pulmonary vein isolation in a single center. The study analyzed the AF recurrence and assessed the CBA indexes, including nadir temperature, time-to-isolation, CBA failure, pulmonary vein potentials (PVPs), and redo procedure. RESULTS: < 0.001, respectively). CONCLUSIONS: The CBA can be effectively and safely used to treat HCM patients with symptomatic AF. The freedom from AF for HCM patients after CBA is relatively low compared to that for non-HCM patients.
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Cao et al. (2020) conducted a case-control in Symptomatic atrial fibrillation (n=108). Hypertrophic cardiomyopathy vs. Non-hypertrophic cardiomyopathy was evaluated on Atrial fibrillation recurrence (reported as two-year AF-free rate) (HR 2.74, 95% CI 1.29-5.79, p=0.008). Hypertrophic cardiomyopathy was independently associated with a higher risk of atrial fibrillation recurrence after cryoballoon ablation compared to non-HCM patients (HR 2.74).
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