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

Clinical and pathophysiologic determinants of catheter ablation outcome in hypertrophic cardiomyopathy with atrial fibrillation

“…Rhythm control in AF‐HCM patients is a valuable option, but there is controversy whether the effect of AFCA is inferior to that in non‐HCM patients. Some studies have reported lower success rates and higher requirements for repeat AFCA procedures in AF‐HCM patients, and it might be attributable to a hypertrophied LA wall 2,8,11–14,16 . Contrary to the previous reports, we observed similar rhythm outcomes after the AFCA in patients with HCM as compared to those without.…”

“…Some studies have reported lower success rates and higher requirements for repeat AFCA procedures in AF-HCM patients, and it might be attributable to a hypertrophied LA wall. 2,8,[11][12][13][14]16 Contrary to the previous reports, we observed similar rhythm outcomes after the AFCA in patients with HCM as compared to those without. In addition, our study showed that the presence of HCM did not affect wall thickness of LA, which was consistent with a previous study by Hayashi et al 15 Furthermore, our study examined the impact of the type of HCM on the rhythm outcome, and surprisingly, the recurrence rate between the apical HCM group and the control group did not differ significantly, while we observed that nonapical HCM patients had a worse rhythm outcome than both the apical HCM and control groups.…”

“…Previous studies reported that AFCA is still effective choice for maintaining sinus rhythm in HCM patients although AFCA is not as efficacious in HCM patients compared to AF patients with no structural heart disease. 14,29 In this study, we investigate repeat procedural findings in AF-HCM and control groups, and the results revealed that the PV reconnection rate and the existence of extra-PV triggers during the repeat procedure did not differ between two groups. These findings might suggest that LV diastolic function may have played a more significant role in the hemodynamics and reverse remodeling of the LA and may have affected AF recurrence rate after de novo AFCA in AF patients with HCM.…”

“…2,[7][8][9][10] The outcomes of AFCA in AF-HCM patients have been evaluated in only a few clinical studies with inconsistent results, ranging from lower success rates and higher need for repeated procedures to equivalent success rates to those without structural heart disease. 2,8,[11][12][13][14][15][16] This disparity in findings highlights the need for further investigation into the factors that may impact the effectiveness of AFCA in AF-HCM patients. Therefore, in this study, we compared clinical, echocardiographic, and electrophysiological parameters between patients with and without HCM and among HCM subtypes (apical versus nonapical) at the time of AFCA, while also analyzing reverse remodeling and the recurrence of AF after the AFCA based on HCM presence and subtype.…”

“…The outcomes of AFCA in AF‐HCM patients have been evaluated in only a few clinical studies with inconsistent results, ranging from lower success rates and higher need for repeated procedures to equivalent success rates to those without structural heart disease 2,8,11–16 . This disparity in findings highlights the need for further investigation into the factors that may impact the effectiveness of AFCA in AF‐HCM patients.…”