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Atrial fibrillation in hypertrophic cardiomyopathy: pathophysiology, diagnosis and management

Giulio Falasconi1,2, Luigi Pannone1,2, Massimo Slavich1

  • 1Clinical Cardiology Unit, IRCCS San Raffaele University Hospital Milan, Italy.

American Journal of Cardiovascular Disease
|November 23, 2020
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) is a common inherited heart condition. Atrial fibrillation (AF) frequently occurs with HCM, worsening patient outcomes and increasing risks of heart failure and stroke.

Area of Science:

  • Cardiology
  • Genetics
  • Electrophysiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiac condition.
  • HCM is a primary cause of sudden cardiac death in young individuals.
  • Atrial fibrillation (AF) affects 20-25% of HCM patients, complicating prognosis.

Purpose of the Study:

  • To review the association between hypertrophic cardiomyopathy and atrial fibrillation.
  • To discuss the multifactorial genesis of AF in HCM.
  • To outline current management strategies for AF in HCM patients.

Main Methods:

  • Literature review of existing studies on HCM and AF.
  • Analysis of AF prevalence and contributing factors in HCM.
  • Synthesis of therapeutic approaches for AF management in this population.

Main Results:

  • AF is a common comorbidity in HCM, linked to genetic and hemodynamic factors.
  • The presence of AF exacerbates HCM, increasing risks for heart failure and stroke.
  • Established strategies exist for managing AF episodes and preventing recurrence in HCM.

Conclusions:

  • AF significantly worsens the prognosis for patients with hypertrophic cardiomyopathy.
  • Understanding AF's multifactorial origins in HCM is crucial for effective management.
  • Current therapeutic options offer means to control AF and mitigate its adverse effects in HCM.

Keywords:
Atrial fibrillationhypertrophic cardiomyopathypharmacological therapy

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