PMID- 20173211
OWN - NLM
STAT- MEDLINE
DCOM- 20100507
LR  - 20161125
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 12
IP  - 3
DP  - 2010 Mar
TI  - Efficacy of catheter ablation for atrial fibrillation in hypertrophic 
      cardiomyopathy: impact of age, atrial remodelling, and disease progression.
PG  - 347-55
LID - 10.1093/europace/euq013 [doi]
AB  - AIMS: In patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation 
      (AF), radiofrequency catheter ablation (RFCA) represents a promising option. 
      However, the predictors of RFCA efficacy remain largely unknown. We assessed the 
      outcome of a multicentre HCM cohort following RFCA for symptomatic AF refractory 
      to medical therapy. METHODS AND RESULTS: Sixty-one patients (age 54 +/- 13 years; 
      time from AF onset 5.7 +/- 5.5 years) with paroxysmal (n = 35; 57%), recent 
      persistent (n = 15; 25%), or long-standing persistent AF (n = 11; 18%) were 
      enrolled. A scheme with pulmonary vein isolation plus linear lesions was 
      employed. Of the 61 patients, 32 (52%) required redo procedures. Antiarrhythmic 
      therapy was maintained in 22 (54%). At the end of a 29 +/- 16 months follow-up, 
      41 patients (67%) were in sinus rhythm, including 17 of the 19 patients aged < or 
      = 50 years, with marked improvement in New York Heart Association (NYHA) 
      functional class (1.2 +/- 0.5 vs. 1.9 +/- 0.7 at baseline; P < 0.001). In the 
      remaining 20 patients (33%), with AF recurrence, there was less marked, but still 
      significant, improvement following RFCA (NYHA class 1.8 +/- 0.7 vs. 2.3 +/- 0.7 
      at baseline; P = 0.002). Independent predictors of AF recurrence were increased 
      left atrium volume [hazard ratio (HR) per unit increase 1.009, 95% confidence 
      interval (CI) 1.001-1.018; P = 0.037] and NYHA functional class (HR 2.24, 95% CI 
      1.16-4.35; P = 0.016). Among 11 genotyped HCM patients (6 with MYBPC3, 2 with 
      MYH7, 1 with MYL2 and 2 with multiple mutations), RFCA success rate was 
      comparable with that of the overall cohort (n = 8; 73%). CONCLUSION: RFCA was 
      successful in restoring long-term sinus rhythm and improving symptomatic status 
      in most HCM patients with refractory AF, including the subset with proven 
      sarcomere gene mutations, although redo procedures were often necessary. Younger 
      HCM patients with small atrial size and mild symptoms proved to be the best RFCA 
      candidates, likely due to lesser degrees of atrial remodelling.
FAU - Di Donna, Paolo
AU  - Di Donna P
AD  - Division of Cardiology, Cardinal Massaia Hospital of Asti and Faculty of 
      Medicine, University of Turin, Corso Dante, 202, Asti 14100, Italy. 
      didonna@asl.at.it
FAU - Olivotto, Iacopo
AU  - Olivotto I
FAU - Delcre, Sara Dalila Luisella
AU  - Delcre SD
FAU - Caponi, Domenico
AU  - Caponi D
FAU - Scaglione, Marco
AU  - Scaglione M
FAU - Nault, Isabelle
AU  - Nault I
FAU - Montefusco, Antonio
AU  - Montefusco A
FAU - Girolami, Francesca
AU  - Girolami F
FAU - Cecchi, Franco
AU  - Cecchi F
FAU - Haissaguerre, Michel
AU  - Haissaguerre M
FAU - Gaita, Fiorenzo
AU  - Gaita F
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Atrial Fibrillation/*complications/drug therapy/*surgery
MH  - Cardiomyopathy, Hypertrophic/*complications/diagnostic imaging/genetics
MH  - *Catheter Ablation
MH  - Combined Modality Therapy
MH  - Disease Progression
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Genetic Testing
MH  - Genotype
MH  - Heart Atria/diagnostic imaging
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Treatment Outcome
EDAT- 2010/02/23 06:00
MHDA- 2010/05/08 06:00
CRDT- 2010/02/23 06:00
PHST- 2010/02/23 06:00 [entrez]
PHST- 2010/02/23 06:00 [pubmed]
PHST- 2010/05/08 06:00 [medline]
AID - euq013 [pii]
AID - 10.1093/europace/euq013 [doi]
PST - ppublish
SO  - Europace. 2010 Mar;12(3):347-55. doi: 10.1093/europace/euq013.