Atrial fibrillation in patients with left ventricular non-compaction: incidence and associations with stroke, heart

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Amir Askarinejad1, Thomas F Lüscher2,3,4,5, Gregory Y H Lip1,6,7

  • 1Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, 6 W Derby St, Liverpool L7 8TX, UK.

Cardiovascular Research
|July 9, 2026
PubMed

Insights

Left ventricular non-compaction (LVNC) is linked to a high incidence of atrial fibrillation (AF). Patients with LVNC and AF face increased risks of stroke, heart failure, and death compared to those without AF.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Left ventricular non-compaction (LVNC) is a genetic cardiomyopathy with variable clinical presentations, including heart failure and stroke.
  • The association between LVNC and atrial fibrillation (AF) risk is not well-established, despite potential links due to structural and functional abnormalities.

Purpose of the Study:

  • To determine the incidence of AF in patients diagnosed with LVNC.
  • To compare the clinical outcomes of patients with LVNC who develop AF versus those who do not.

Main Methods:

  • A retrospective observational study using the TriNetX platform identified two cohorts: LVNC patients without prior AF or stroke, and LVNC patients with AF but no prior stroke.
  • Propensity score matching (PSM) was employed to balance baseline characteristics between the groups.
  • Cox proportional models were used to assess the 3-year risk of a composite outcome including all-cause mortality, stroke, acute myocardial infarction, and heart failure.

Main Results:

  • The 1-year incidence of AF in LVNC patients was 36 per 1000 person-years.
  • After PSM, LVNC patients with AF exhibited significantly higher risks of stroke (HR 1.466), new-onset heart failure (HR 1.439), all-cause death (HR 1.255), and the composite outcome (HR 1.301) compared to LVNC patients without AF.
  • Patients with LVNC and AF were older and had a greater comorbidity burden.

Conclusions:

  • LVNC is associated with a substantial incidence of AF.
  • The presence of AF in LVNC patients significantly increases their risk for adverse cardiovascular events, including stroke, heart failure, and mortality.
  • Further prospective research is needed to fully elucidate the prognostic implications of AF in the context of LVNC.
Abstract

Keywords:
Atrial fibrillationLeft ventricular non-compactionStroke

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