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Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome

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Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome. / Dinshaw, Leon; Münkler, Paula; Schäffer, Benjamin; Klatt, Niklas; Jungen, Christiane; Dickow, Jannis; Tamenang, Annika; Schleberger, Ruben; Pecha, Simon; Pinnschmidt, Hans; Patten, Monica; Reichenspurner, Hermann; Willems, Stephan; Meyer, Christian.

In: J AM HEART ASSOC, Vol. 10, No. 3, 02.02.2021, p. e017451.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Dinshaw, L, Münkler, P, Schäffer, B, Klatt, N, Jungen, C, Dickow, J, Tamenang, A, Schleberger, R, Pecha, S, Pinnschmidt, H, Patten, M, Reichenspurner, H, Willems, S & Meyer, C 2021, 'Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome', J AM HEART ASSOC, vol. 10, no. 3, pp. e017451. https://doi.org/10.1161/JAHA.120.017451

APA

Dinshaw, L., Münkler, P., Schäffer, B., Klatt, N., Jungen, C., Dickow, J., Tamenang, A., Schleberger, R., Pecha, S., Pinnschmidt, H., Patten, M., Reichenspurner, H., Willems, S., & Meyer, C. (2021). Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome. J AM HEART ASSOC, 10(3), e017451. https://doi.org/10.1161/JAHA.120.017451

Vancouver

Dinshaw L, Münkler P, Schäffer B, Klatt N, Jungen C, Dickow J et al. Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome. J AM HEART ASSOC. 2021 Feb 2;10(3):e017451. https://doi.org/10.1161/JAHA.120.017451

Bibtex

@article{bb00f339c4f14a24b8558e2ce5913252,
title = "Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome",
abstract = "Background: Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and is associated with a deterioration of clinical status. Ablation of symptomatic AF is an established therapy, but in HCM, the characteristics of recurrent atrial arrhythmias and the long-term outcome are uncertain. Methods and Results: Sixty-five patients with HCM (aged 64.5±9.9 years, 42 [64.6%] men) underwent AF ablation. The ablation strategy included pulmonary vein isolation in all patients and ablation of complex fractionated atrial electrograms or subsequent atrial tachycardias (AT) if appropriate. Paroxysmal, persistent AF, and a primary AT was present in 13 (20.0%), 51 (78.5%), and 1 (1.5%) patients, respectively. Twenty-five (38.4%) patients developed AT with a total number of 54 ATs. Stable AT was observed in 15 (23.1%) and unstable AT in 10 (15.3%) patients. The mechanism was characterized as a macroreentry in 37 (68.5%), as a localized reentry in 12 (22.2%), a focal mechanism in 1 (1.9%), and not classified in 4 (7.4%) ATs. After 1.9±1.2 ablation procedures and a follow-up of 48.1±32.5 months, freedom of AF/AT recurrences was demonstrated in 60.0% of patients. No recurrences occurred in 84.6% and 52.9% of patients with paroxysmal and persistent AF, respectively (P<0.01). Antiarrhythmic drug therapy was maintained in 24 (36.9%) patients. Conclusions: AF ablation in patients with HCM is effective for long-term rhythm control, and especially patients with paroxysmal AF undergoing pulmonary vein isolation have a good clinical outcome. ATs after AF ablation are frequently observed in HCM. Freedom of atrial arrhythmia is achieved by persistent AF ablation in a reasonable number of patients even though the use of antiarrhythmic drug therapy remains high.",
author = "Leon Dinshaw and Paula M{\"u}nkler and Benjamin Sch{\"a}ffer and Niklas Klatt and Christiane Jungen and Jannis Dickow and Annika Tamenang and Ruben Schleberger and Simon Pecha and Hans Pinnschmidt and Monica Patten and Hermann Reichenspurner and Stephan Willems and Christian Meyer",
year = "2021",
month = feb,
day = "2",
doi = "10.1161/JAHA.120.017451",
language = "English",
volume = "10",
pages = "e017451",
journal = "J AM HEART ASSOC",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "3",

}

RIS

TY - JOUR

T1 - Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long-Term Outcome

AU - Dinshaw, Leon

AU - Münkler, Paula

AU - Schäffer, Benjamin

AU - Klatt, Niklas

AU - Jungen, Christiane

AU - Dickow, Jannis

AU - Tamenang, Annika

AU - Schleberger, Ruben

AU - Pecha, Simon

AU - Pinnschmidt, Hans

AU - Patten, Monica

AU - Reichenspurner, Hermann

AU - Willems, Stephan

AU - Meyer, Christian

PY - 2021/2/2

Y1 - 2021/2/2

N2 - Background: Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and is associated with a deterioration of clinical status. Ablation of symptomatic AF is an established therapy, but in HCM, the characteristics of recurrent atrial arrhythmias and the long-term outcome are uncertain. Methods and Results: Sixty-five patients with HCM (aged 64.5±9.9 years, 42 [64.6%] men) underwent AF ablation. The ablation strategy included pulmonary vein isolation in all patients and ablation of complex fractionated atrial electrograms or subsequent atrial tachycardias (AT) if appropriate. Paroxysmal, persistent AF, and a primary AT was present in 13 (20.0%), 51 (78.5%), and 1 (1.5%) patients, respectively. Twenty-five (38.4%) patients developed AT with a total number of 54 ATs. Stable AT was observed in 15 (23.1%) and unstable AT in 10 (15.3%) patients. The mechanism was characterized as a macroreentry in 37 (68.5%), as a localized reentry in 12 (22.2%), a focal mechanism in 1 (1.9%), and not classified in 4 (7.4%) ATs. After 1.9±1.2 ablation procedures and a follow-up of 48.1±32.5 months, freedom of AF/AT recurrences was demonstrated in 60.0% of patients. No recurrences occurred in 84.6% and 52.9% of patients with paroxysmal and persistent AF, respectively (P<0.01). Antiarrhythmic drug therapy was maintained in 24 (36.9%) patients. Conclusions: AF ablation in patients with HCM is effective for long-term rhythm control, and especially patients with paroxysmal AF undergoing pulmonary vein isolation have a good clinical outcome. ATs after AF ablation are frequently observed in HCM. Freedom of atrial arrhythmia is achieved by persistent AF ablation in a reasonable number of patients even though the use of antiarrhythmic drug therapy remains high.

AB - Background: Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and is associated with a deterioration of clinical status. Ablation of symptomatic AF is an established therapy, but in HCM, the characteristics of recurrent atrial arrhythmias and the long-term outcome are uncertain. Methods and Results: Sixty-five patients with HCM (aged 64.5±9.9 years, 42 [64.6%] men) underwent AF ablation. The ablation strategy included pulmonary vein isolation in all patients and ablation of complex fractionated atrial electrograms or subsequent atrial tachycardias (AT) if appropriate. Paroxysmal, persistent AF, and a primary AT was present in 13 (20.0%), 51 (78.5%), and 1 (1.5%) patients, respectively. Twenty-five (38.4%) patients developed AT with a total number of 54 ATs. Stable AT was observed in 15 (23.1%) and unstable AT in 10 (15.3%) patients. The mechanism was characterized as a macroreentry in 37 (68.5%), as a localized reentry in 12 (22.2%), a focal mechanism in 1 (1.9%), and not classified in 4 (7.4%) ATs. After 1.9±1.2 ablation procedures and a follow-up of 48.1±32.5 months, freedom of AF/AT recurrences was demonstrated in 60.0% of patients. No recurrences occurred in 84.6% and 52.9% of patients with paroxysmal and persistent AF, respectively (P<0.01). Antiarrhythmic drug therapy was maintained in 24 (36.9%) patients. Conclusions: AF ablation in patients with HCM is effective for long-term rhythm control, and especially patients with paroxysmal AF undergoing pulmonary vein isolation have a good clinical outcome. ATs after AF ablation are frequently observed in HCM. Freedom of atrial arrhythmia is achieved by persistent AF ablation in a reasonable number of patients even though the use of antiarrhythmic drug therapy remains high.

U2 - 10.1161/JAHA.120.017451

DO - 10.1161/JAHA.120.017451

M3 - SCORING: Journal article

C2 - 33455428

VL - 10

SP - e017451

JO - J AM HEART ASSOC

JF - J AM HEART ASSOC

SN - 2047-9980

IS - 3

ER -