Atrial fibrillation in hypertrophic cardiomyopathy is a distinct clinical entity occurring in 20-25% of patients, requiring dedicated investigation due to worse outcomes than non-HCM AF.
Highlights the need for dedicated studies on atrial fibrillation in hypertrophic cardiomyopathy, as it represents a distinct clinical entity with unique mechanisms and worse outcomes compared to non-HCM AF.
Atrial fibrillation (AF) is the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM) occurring in 20-25% of patients and associated with significant morbidity including stroke risk and worsening heart failure. Atrial fibrillation in HCM (HCM-AF) arises from disease-specific mechanisms distinct from non-HCM AF including HCM-related atrial structural changes (dilation/ fibrosis), biophysical abnormalities (within ion-channels), and atrial dysfunction that culminate in an HCM specific atrial-myopathy. While the adoption of contemporary AF therapies have been associated with improved clinical outcomes in non-HCM-AF populations, HCM-AF outcomes nonetheless remain worse including lower rates of rhythm control success with catheter ablation and antiarrhythmic medications. In this context, we provide support that HCM-AF is a distinct clinical entity, highlighting gaps in knowledge and care, and represents an area of need for dedicated investigation as it is unclear the effectiveness of applying therapeutics from non-HCM AF populations to HCM-AF.
Rowin et al. (Wed,) conducted a review in Atrial Fibrillation in Hypertrophic Cardiomyopathy. Atrial fibrillation in hypertrophic cardiomyopathy is a distinct clinical entity occurring in 20-25% of patients, requiring dedicated investigation due to worse outcomes than non-HCM AF.