Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-190 - Catheter Ablation For Atrial Fibrillation In Hypertrophic Cardiomyopathy: A Systematic Review And Meta-analysis (ID 358)

 R. Chaudhary: Nothing relevant to disclose.


Background: Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients is associated with deterioration of their clinical condition, such as worsening heart failure, and an increased thromboembolic stroke risk and cardiac mortality rate.
Objective: We aimed to perform meta-analysis of observational studies to determine the efficacy and safety of catheter ablation of AF in patients with HCM versus non HCM controls.
Methods: Studies were searched on PUBMED, MEDLINE, EMBASE, COCHRANE and Mantel-Haenszel risk ratio (RR) random effects model was used to summarize data between the two groups. Heterogeneity was assessed using I2 statistics. The outcomes of freedom from AF/atrial tachycardia, and freedom from anti-arrhythmic drugs were assessed.
Results: Nine studies met the inclusion criteria (mean age 58.29 ± 3.76 years, follow up duration 9 months to 4.5 years). Freedom from AF/atrial tachycardia relapse was higher in patients without HCM (after a single procedure, 42.7% HCM vs 61.18% controls, RR 0.78, 95% CI 0.65 to 0.93, p = 0.006; I2 = 27% and after >1 procedure, 51.68% HCM vs 71.30% controls, RR 0.77, 95% CI 0.66 to 0.88, p<0.001; I2 = 19%). Non-HCM patients had increased freedom from antiarrhythmic drugs during the follow period (51.04% HCM vs 75.43% controls, RR 0.67, 95% CI 0.55 to 0.82, p<0.001; I2 = 9%). Risk of procedure related adverse effects was low in both groups.
Conclusion: Although outcomes seem less favorable in patients with HCM than the general population, with more frequent need of repeat procedures and concomitant use of antiarrhythmic drugs, ablation can be a valuable option for symptomatic drug-refractory patients with HCM.