Efficacy of Catheter Ablation for Atrial Fibrillation in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis

Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) has emerged as an effective therapy for AF. We conducted a meta-analysis to update the current clinical evidence on the efficacy of CA for AF in patients with HCM. We sea...

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Published in:Current problems in cardiology 2023-03, Vol.48 (3), p.101524-101524, Article 101524
Main Authors: Faraz, Fatima, Rehman, Mohammad Ebad Ur, Sabir, Beenish, Ghaffar, Areeba, Iftikhar, Ahmad, Maqsood, Aimen, Ahmad Cheema, Huzaifa, Yasmin, Farah, Aamir, Muhammad, Ahmed, Muhammad Umer, Asghar, Muhammad Sohaib
Format: Article
Language:English
Subjects:
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - complications
Atrial Fibrillation - drug therapy
Atrial Fibrillation - surgery
Cardiomyopathy, Hypertrophic - complications
Cardiomyopathy, Hypertrophic - surgery
Catheter Ablation - methods
Humans
Treatment Outcome
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Summary:Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) has emerged as an effective therapy for AF. We conducted a meta-analysis to update the current clinical evidence on the efficacy of CA for AF in patients with HCM. We searched PubMed, Embase, Cochrane and Clinicaltrials.gov for interventional and observational studies assessing single and multiple procedure success rate of CA in HCM patients. Our meta-analysis included 25 studies involving 1817 patients. Success rate following single procedure was 40.4% (95% CI 33.1 to 48.0%) at latest follow-up. The pooled success rate following multiple procedures was 51.4% (95% CI 42.9% to 60.0%) at latest follow-up. In the subgroup analysis for AF subtype, TCA was more successful for paroxysmal AF compared to non-paroxysmal AF. For the subset of studies reporting drug-free success rate, single and multiple procedures had a success rate of 33.4% (95% CI 19.3 to 49.1%) and 51.8% (95% CI 41.3 to 62.2%) at latest follow-up, respectively. CA is a suitable option for AF in patients with HCM. Success rate is greater in paroxysmal AF, after multiple procedures and with antiarrhythmic drugs.
ISSN:0146-2806
1535-6280
DOI:10.1016/j.cpcardiol.2022.101524