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Heartbeat: Is atrial fibrillation ablation effective in patients with hypertrophic cardiomyopathy?
  1. Kazem Rahimi,
  2. Catherine M Otto
  1. Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; cmotto{at}

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Atrial fibrillation (AF) is a common co-morbidity in patients with hypertrophic cardiomyopathy (HCM) and it can contribute to poor outcomes. Therefore, identification of safe and effective strategies for controlling AF in HCM are of substantial interest to researchers, clinicians and patients.

In this issue of Heart, Providencia and colleagues (see page 1533) report the findings from a systematic review and meta-analysis of published literature which takes a closer look at the safety and efficacy of AF ablation in HCM. The authors identify 15 potentially relevant studies and pool data from 4 cohort studies to compare the rates of success and complications after AF ablation in patients with HCM with those without HCM. They showed that people with HCM are about 2 times more likely to have a relapse after a single ablation therapy than those without HCM (OR 2.25, CI 1.09 to 4.64) (figure 1). They further note that HCM patients are more likely to be prescribed anti-arrhythmic drugs but overall the risk of adverse events after ablation therapy seems low. In exploratory subgroup analyses, they generate the hypothesis that the differences in success rates after ablation therapy between the HCM and non-HCM patients may be due to larger atrial size and/or higher rate of persistent AF in HCM than those without HCM.

Figure 1

Forest plots comparing procedural outcomes (freedom from AF/AT relapse) of catheter ablation of AF in patients with and without HCM. AF, atrial fibrillation; AT, atrial tachycardia; HCM, hypertrophic cardiomyopathy.

In an accompanying editorial, Prutkin and Owens (see page …

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