Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical impact, and management

Hypertrophic cardiomyopathy (HCM) is the most common hereditary cardiomyopathy characterized by left ventricular hypertrophy and spectrum of clinical manifestation. Atrial fibrillation (AF) is a common sustained arrhythmia in HCM patients and is primarily related to left atrial dilatation and remode...

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Bibliographic Details
Published in:Heart failure reviews 2019-03, Vol.24 (2), p.189-197
Main Authors: Garg, Lohit, Gupta, Manasvi, Sabzwari, Syed Rafay Ali, Agrawal, Sahil, Agarwal, Manyoo, Nazir, Talha, Gordon, Jeffrey, Bozorgnia, Babak, Martinez, Matthew W.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Arrhythmia Agents - therapeutic use
Anticoagulants - therapeutic use
Arrhythmia
Atrial Fibrillation - complications
Atrial Fibrillation - drug therapy
Atrial Fibrillation - mortality
Atrial Fibrillation - physiopathology
Atrial Remodeling - physiology
Cardiac arrhythmia
Cardiology
Cardiomyopathy
Cardiomyopathy, Hypertrophic - complications
Cardiomyopathy, Hypertrophic - epidemiology
Echocardiography - methods
EKG
Electrocardiography
Electrocardiography - methods
Fibrillation
Heart Atria - diagnostic imaging
Heart diseases
Heart failure
Heart Failure - classification
Heart Failure - physiopathology
Humans
Hypertrophy
Medicine
Medicine & Public Health
Middle Aged
Prevalence
Risk Factors
Thromboembolism
Thromboembolism - etiology
Thromboembolism - prevention & control
Ventricle
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Description
Summary:Hypertrophic cardiomyopathy (HCM) is the most common hereditary cardiomyopathy characterized by left ventricular hypertrophy and spectrum of clinical manifestation. Atrial fibrillation (AF) is a common sustained arrhythmia in HCM patients and is primarily related to left atrial dilatation and remodeling. There are several clinical, electrocardiographic (ECG), and echocardiographic (ECHO) features that have been associated with development of AF in HCM patients; strongest predictors are left atrial size, age, and heart failure class. AF can lead to progressive functional decline, worsening heart failure and increased risk for systemic thromboembolism. The management of AF in HCM patient focuses on symptom alleviation (managed with rate and/or rhythm control methods) and prevention of complications such as thromboembolism (prevented with anticoagulation). Finally, recent evidence suggests that early rhythm control strategy may result in more favorable short- and long-term outcomes.
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-018-9752-6