Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy

Mohamed Bassiouny, Bruce D. Lindsay, Harry Lever, Walid Saliba, Allan Klein, Moustafa Banna, Joellyn Abraham, Mingyuan Shao, John Rickard, Mohamed Kanj, Patrick Tchou, Thomas Dresing, Bryan Baranowski, Mandeep Bhargava, Thomas Callahan, Khaldoun Tarakji, Daniel Cantillon, Ayman Hussein, A. Marc Gillinov, Nicholas G. SmediraOussama Wazni

Research output: Contribution to journalArticle

Abstract

Background Limited data exist regarding the outcome of atrial fibrillation (AF) surgery and catheter ablation in patients with hypertrophic cardiomyopathy (HCM). Objective The purpose of this study was to evaluate the safety and efficacy of nonpharmacologic treatment of AF in HCM. Methods One hundred forty-seven patients (46 female, age 55 ± 11 years, ejection fraction [EF] 58% ± 8%) with symptomatic paroxysmal (58%), persistent (31%), and long-standing persistent AF (11%) refractory to antiarrhythmic drugs who presented for their first catheter ablation (n = 79) or AF surgery (n = 68) were included. Results After follow-up of 35 months (interquartile range 13, 60), 29% of patients who underwent catheter ablation and 51% of those who had undergone AF surgery had no documented recurrent atrial arrhythmia after a single procedure. Repeat ablation was performed in 55% of patients with recurrent arrhythmia in the catheter group and 24% in the surgery group, increasing the success rate to 39% and 53%, respectively, after 1 or more procedures. Predictors of success after the first procedure in a multivariable setting included higher baseline EF and male gender. Persistent or long-standing AF and log of AF duration were associated with lower success. Major complications occurred in 6% of the catheter ablation group and 18% of the AF surgery group. During follow-up, 16 patients died (9 in catheter group, 7 in surgery group) and 1 underwent heart replacement. Lower baseline EF and older age were independently associated with death. Conclusion Catheter ablation and AF surgery are associated with symptomatic improvement in HCM patients. However, long-term success is lower and complications are higher than previously reported.

Original languageEnglish (US)
Pages (from-to)1438-1447
Number of pages10
JournalHeart Rhythm
Volume12
Issue number7
DOIs
StatePublished - Jul 1 2015

Fingerprint

Hypertrophic Cardiomyopathy
Atrial Fibrillation
Catheter Ablation
Cardiac Arrhythmias
Catheters
Anti-Arrhythmia Agents
Safety

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Hypertrophic cardiomyopathy
  • Maze procedure
  • Pulmonary vein isolation
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Bassiouny, M., Lindsay, B. D., Lever, H., Saliba, W., Klein, A., Banna, M., ... Wazni, O. (2015). Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy. Heart Rhythm, 12(7), 1438-1447. https://doi.org/10.1016/j.hrthm.2015.03.042

Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy. / Bassiouny, Mohamed; Lindsay, Bruce D.; Lever, Harry; Saliba, Walid; Klein, Allan; Banna, Moustafa; Abraham, Joellyn; Shao, Mingyuan; Rickard, John; Kanj, Mohamed; Tchou, Patrick; Dresing, Thomas; Baranowski, Bryan; Bhargava, Mandeep; Callahan, Thomas; Tarakji, Khaldoun; Cantillon, Daniel; Hussein, Ayman; Marc Gillinov, A.; Smedira, Nicholas G.; Wazni, Oussama.

In: Heart Rhythm, Vol. 12, No. 7, 01.07.2015, p. 1438-1447.

Research output: Contribution to journalArticle

Bassiouny, M, Lindsay, BD, Lever, H, Saliba, W, Klein, A, Banna, M, Abraham, J, Shao, M, Rickard, J, Kanj, M, Tchou, P, Dresing, T, Baranowski, B, Bhargava, M, Callahan, T, Tarakji, K, Cantillon, D, Hussein, A, Marc Gillinov, A, Smedira, NG & Wazni, O 2015, 'Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy', Heart Rhythm, vol. 12, no. 7, pp. 1438-1447. https://doi.org/10.1016/j.hrthm.2015.03.042
Bassiouny, Mohamed ; Lindsay, Bruce D. ; Lever, Harry ; Saliba, Walid ; Klein, Allan ; Banna, Moustafa ; Abraham, Joellyn ; Shao, Mingyuan ; Rickard, John ; Kanj, Mohamed ; Tchou, Patrick ; Dresing, Thomas ; Baranowski, Bryan ; Bhargava, Mandeep ; Callahan, Thomas ; Tarakji, Khaldoun ; Cantillon, Daniel ; Hussein, Ayman ; Marc Gillinov, A. ; Smedira, Nicholas G. ; Wazni, Oussama. / Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy. In: Heart Rhythm. 2015 ; Vol. 12, No. 7. pp. 1438-1447.
@article{ab6e41a8f48a471d9a215cb5ade8cc2c,
title = "Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy",
abstract = "Background Limited data exist regarding the outcome of atrial fibrillation (AF) surgery and catheter ablation in patients with hypertrophic cardiomyopathy (HCM). Objective The purpose of this study was to evaluate the safety and efficacy of nonpharmacologic treatment of AF in HCM. Methods One hundred forty-seven patients (46 female, age 55 ± 11 years, ejection fraction [EF] 58{\%} ± 8{\%}) with symptomatic paroxysmal (58{\%}), persistent (31{\%}), and long-standing persistent AF (11{\%}) refractory to antiarrhythmic drugs who presented for their first catheter ablation (n = 79) or AF surgery (n = 68) were included. Results After follow-up of 35 months (interquartile range 13, 60), 29{\%} of patients who underwent catheter ablation and 51{\%} of those who had undergone AF surgery had no documented recurrent atrial arrhythmia after a single procedure. Repeat ablation was performed in 55{\%} of patients with recurrent arrhythmia in the catheter group and 24{\%} in the surgery group, increasing the success rate to 39{\%} and 53{\%}, respectively, after 1 or more procedures. Predictors of success after the first procedure in a multivariable setting included higher baseline EF and male gender. Persistent or long-standing AF and log of AF duration were associated with lower success. Major complications occurred in 6{\%} of the catheter ablation group and 18{\%} of the AF surgery group. During follow-up, 16 patients died (9 in catheter group, 7 in surgery group) and 1 underwent heart replacement. Lower baseline EF and older age were independently associated with death. Conclusion Catheter ablation and AF surgery are associated with symptomatic improvement in HCM patients. However, long-term success is lower and complications are higher than previously reported.",
keywords = "Atrial fibrillation, Catheter ablation, Hypertrophic cardiomyopathy, Maze procedure, Pulmonary vein isolation, Surgery",
author = "Mohamed Bassiouny and Lindsay, {Bruce D.} and Harry Lever and Walid Saliba and Allan Klein and Moustafa Banna and Joellyn Abraham and Mingyuan Shao and John Rickard and Mohamed Kanj and Patrick Tchou and Thomas Dresing and Bryan Baranowski and Mandeep Bhargava and Thomas Callahan and Khaldoun Tarakji and Daniel Cantillon and Ayman Hussein and {Marc Gillinov}, A. and Smedira, {Nicholas G.} and Oussama Wazni",
year = "2015",
month = "7",
day = "1",
doi = "10.1016/j.hrthm.2015.03.042",
language = "English (US)",
volume = "12",
pages = "1438--1447",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",
number = "7",

}

TY - JOUR

T1 - Outcomes of nonpharmacologic treatment of atrial fibrillation in patients with hypertrophic cardiomyopathy

AU - Bassiouny, Mohamed

AU - Lindsay, Bruce D.

AU - Lever, Harry

AU - Saliba, Walid

AU - Klein, Allan

AU - Banna, Moustafa

AU - Abraham, Joellyn

AU - Shao, Mingyuan

AU - Rickard, John

AU - Kanj, Mohamed

AU - Tchou, Patrick

AU - Dresing, Thomas

AU - Baranowski, Bryan

AU - Bhargava, Mandeep

AU - Callahan, Thomas

AU - Tarakji, Khaldoun

AU - Cantillon, Daniel

AU - Hussein, Ayman

AU - Marc Gillinov, A.

AU - Smedira, Nicholas G.

AU - Wazni, Oussama

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Background Limited data exist regarding the outcome of atrial fibrillation (AF) surgery and catheter ablation in patients with hypertrophic cardiomyopathy (HCM). Objective The purpose of this study was to evaluate the safety and efficacy of nonpharmacologic treatment of AF in HCM. Methods One hundred forty-seven patients (46 female, age 55 ± 11 years, ejection fraction [EF] 58% ± 8%) with symptomatic paroxysmal (58%), persistent (31%), and long-standing persistent AF (11%) refractory to antiarrhythmic drugs who presented for their first catheter ablation (n = 79) or AF surgery (n = 68) were included. Results After follow-up of 35 months (interquartile range 13, 60), 29% of patients who underwent catheter ablation and 51% of those who had undergone AF surgery had no documented recurrent atrial arrhythmia after a single procedure. Repeat ablation was performed in 55% of patients with recurrent arrhythmia in the catheter group and 24% in the surgery group, increasing the success rate to 39% and 53%, respectively, after 1 or more procedures. Predictors of success after the first procedure in a multivariable setting included higher baseline EF and male gender. Persistent or long-standing AF and log of AF duration were associated with lower success. Major complications occurred in 6% of the catheter ablation group and 18% of the AF surgery group. During follow-up, 16 patients died (9 in catheter group, 7 in surgery group) and 1 underwent heart replacement. Lower baseline EF and older age were independently associated with death. Conclusion Catheter ablation and AF surgery are associated with symptomatic improvement in HCM patients. However, long-term success is lower and complications are higher than previously reported.

AB - Background Limited data exist regarding the outcome of atrial fibrillation (AF) surgery and catheter ablation in patients with hypertrophic cardiomyopathy (HCM). Objective The purpose of this study was to evaluate the safety and efficacy of nonpharmacologic treatment of AF in HCM. Methods One hundred forty-seven patients (46 female, age 55 ± 11 years, ejection fraction [EF] 58% ± 8%) with symptomatic paroxysmal (58%), persistent (31%), and long-standing persistent AF (11%) refractory to antiarrhythmic drugs who presented for their first catheter ablation (n = 79) or AF surgery (n = 68) were included. Results After follow-up of 35 months (interquartile range 13, 60), 29% of patients who underwent catheter ablation and 51% of those who had undergone AF surgery had no documented recurrent atrial arrhythmia after a single procedure. Repeat ablation was performed in 55% of patients with recurrent arrhythmia in the catheter group and 24% in the surgery group, increasing the success rate to 39% and 53%, respectively, after 1 or more procedures. Predictors of success after the first procedure in a multivariable setting included higher baseline EF and male gender. Persistent or long-standing AF and log of AF duration were associated with lower success. Major complications occurred in 6% of the catheter ablation group and 18% of the AF surgery group. During follow-up, 16 patients died (9 in catheter group, 7 in surgery group) and 1 underwent heart replacement. Lower baseline EF and older age were independently associated with death. Conclusion Catheter ablation and AF surgery are associated with symptomatic improvement in HCM patients. However, long-term success is lower and complications are higher than previously reported.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Hypertrophic cardiomyopathy

KW - Maze procedure

KW - Pulmonary vein isolation

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=84937519944&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937519944&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2015.03.042

DO - 10.1016/j.hrthm.2015.03.042

M3 - Article

C2 - 25814420

AN - SCOPUS:84937519944

VL - 12

SP - 1438

EP - 1447

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 7

ER -