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3127868 
Journal Article 
Long-term Outcome of Catheter Ablation for Atrial Fibrillation in Patients with Apical Hypertrophic Cardiomyopathy 
Roh, SY; Kim, DH; Ahn, J; Lee, KN; Lee, DI; Shim, J; Choi, JI; Park, SW; Kim, YH 
2016 
Yes 
Journal of Cardiovascular Electrophysiology
ISSN: 1045-3873
EISSN: 1540-8167 
English 
27062657 
INTRODUCTION: Atrial fibrillation (AF) is a common manifestation in cases of hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) for AF in patients with asymmetric septal HCM (SeHCM) is selectively effective and often needs a repeat procedure. Apical HCM (ApHCM) has a better prognosis than SeHCM. However, the outcome of CA for AF in patients with ApHCM is unclear.

METHODS AND RESULTS: Eighteen patients with ApHCM (ApHCM group) and 13 SeHCM patients (SeHCM group) underwent CA for AF. Ninety sex-, age-, and AF type-matched non-HCM patients who underwent CA for AF were selected as controls (5 controls for each ApHCM patient). During a median follow-up of 44.7 ± 30.8 months, 50% of the patients remained free from AF/atrial tachycardia (AT) in the ApHCM group. The ApHCM patients displayed enlarged left atrial (LA) diameter (47.1 ± 6.0 mm vs 42.4 ± 5.5 mm, p = 0.006) and increased E/Ea ratio (13.5 ± 4.4 vs. 9.1 ± 3.1, p<0.001) as compared to control group. In contrast, the mean LA diameter and E/Ea ratio of the ApHCM group were not different than those of SeHCM group. The overall freedom from AF/AT in ApHCM group was significantly worse than in control group (Log rank p = 0.028), but there was no difference between the ApHCM and SeHCM groups (p = 0.831). High LA diameter index ≥25 mm/m(2) [HR 12.8, 95% CI (1.2-142.1); P = 0.037] was an independent predictor of AF/AT recurrence among patients with ApHCM.

CONCLUSION: Long-term outcome of CA for AF was worse in patients with ApHCM, as compared to controls, but was similar to patients with SeHCM. This article is protected by copyright. All rights reserved.