Determining Risk of Atrial Fibrillation Among Patients With Hypertrophic Cardiomyopathy

Researchers examined the role of left atrium electrocardiographic and echocardiographic structural and functional parameters as it correlates to predicting the risk for incident atrial fibrillation (AF) among patients with hypertrophic cardiomyopathy (HCM).

“Left atrium booster pump function (ASr) and electrical dispersion (Pd) are related to the risk of incident AF in HCM patients,” wrote study authors.

Of the 126 patients with HCM in sinus rhythm (52.6 ± 16.2 years, 54 men) included in a prospective, moncentric study, 118 of them were not documented having AF.

A new episode of AF was developed in 39 patients (30.9%) during a median follow-up of 56 months.

Multivariable analysis showed that left atrium booster pump function (assessed by ASr, HR=4.24, CI=1.84-9.75, and P = .038) and electrical dispersion (assessed by P wave dispersion - Pd, HR=1.044, CI=1.029-1.058, and P = .001), and not structural parameters (left atrium diameter, left atrium volume) were independent predictors of incident AF,” reported researchers.

During follow-up, 72 patients had a left atrium diameter of <45 mm and 16 of them (22.2%) experienced an AF episode.

According to researchers, only Pd emerged as an independent predictor for incident AF (HR = 1.105, CI=1.059-1.154, and P = .002), with good accuracy (AUC=.89) for this subgroup.

“These parameters can provide further stratification of the risk for AF in this setting, including in patients considered at lower risk for AF based on the conventional assessment of left atrium size,” concluded study authors.

Reference:
Mandeş L, Roşca M, Ciupercă D, et al. Electrocardiographic and echocardiographic predictors of atrial fibrillation in patients with hypertrophic cardiomyopathy. Front Cardiovasc Med. 2022;9:905128. doi:10.3389/fcvm.2022.905128.