Atrial Fibrillation in Hypertrophic Cardiomyopathy
Adaya Weissler‐Snir, Sara Saberi, Timothy C. Wong, Antonis Pantazis, Anjali Owens, Alexander Leunig, Chikezie Alvarez, Florian Rader
Abstract
Atrial fibrillation (AF) is common among patients with hypertrophic cardiomyopathy (HCM) with a prevalence >25%. AF in HCM is associated with a high risk of stroke and can be a marker of more advanced cardiomyopathy. Although, it frequently results in cardiac hemodynamic changes which are poorly tolerated, it can be subclinical. Thus, prompt diagnosis and adequate management of AF are essential to minimizing AF-related adverse outcomes in HCM. All HCM patients should be screened for AF regularly, and those with high-risk features should be screened more frequently preferably with extended ambulatory monitoring. Once AF is detected, oral anticoagulation should be initiated. Both general and HCM-specific modifiable risk factors should be addressed and assessment for cardiomyopathy progression should be performed. Although no randomized controlled studies have compared rate versus rhythm control in HCM, early rhythm control could be considered to prevent further LA remodeling. • AF is common in HCM with a prevalence above 25%. • AF in HCM carries high-risk of stroke and can be a marker of advanced cardiomyopathy. • Prompt diagnosis and adequate management are essential to minimizing AF-related adverse outcomes. • Early rhythm control could be considered to prevent further LA remodeling.