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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Hybrid versus catheter ablation for Hypertrophic CardioMyopathy with Atrial Fibrillation (HCM-AF): study protocol for

Yajie Tang1,2, Le Li1,3, Sipeng Chen4

  • 1State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

BMJ Open
|October 9, 2024
PubMed

Insights

This study compares hybrid ablation to catheter ablation for atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients. It assesses rhythm control effectiveness to improve outcomes in this specific patient group.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Clinical Trials

Background:

  • Atrial fibrillation (AF) is a significant predictor of adverse events in hypertrophic cardiomyopathy (HCM) patients.
  • Catheter ablation (CA) is less effective for maintaining sinus rhythm in HCM patients with AF compared to the general population.
  • Hybrid ablation offers a potentially more effective approach, but comparative data in HCM is lacking.

Purpose of the Study:

  • To compare the rhythm control effectiveness of hybrid ablation versus catheter ablation (CA) in non-obstructive hypertrophic cardiomyopathy (non-oHCM) patients with AF.
  • To evaluate the efficacy of these procedures in maintaining sinus rhythm and reducing AF relapse.
  • To assess the impact on mortality, stroke, heart failure, and quality of life.

Main Methods:

  • A prospective, multicentre, randomized trial with blinded outcome assessment.
  • Sixty-six non-oHCM patients with non-paroxysmal AF randomized 1:1 to hybrid ablation or CA.
  • Primary endpoint: freedom from atrial tachycardia >30s at 12 months without antiarrhythmic drugs; secondary endpoints include mortality, stroke, rehospitalization, and quality of life.

Main Results:

  • This section is not yet available as the study is ongoing.
  • The study is designed to provide definitive comparative data on rhythm control strategies.
  • Results will be disseminated following trial completion.

Conclusions:

  • This trial will provide crucial evidence on the comparative effectiveness of hybrid versus catheter ablation for AF in non-oHCM patients.
  • Findings are expected to guide treatment strategies for this challenging patient population.
  • The study aims to optimize rhythm control and improve long-term outcomes in HCM patients with AF.
Abstract

Keywords:
Adult surgeryCardiomyopathyPacing & electrophysiology

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