Catheter Ablation of Atrial Fibrillation in Hypertrophic Cardiomyopathy

Abstract

Background—Pulmonary vein (PV) antrum isolation in patients with hypertrophic cardiomyopathy and atrial fibrillation (AF) has been reported to have satisfactory results at the mid- and short-term follow-up. We determined the outcomes at the long-term follow-up of PV antrum isolation in these patients. Methods and Results—We enrolled 43 patients with hypertrophic cardiomyopathy and AF (28% paroxysmal AF). PV antrum isolation (paroxysmal AF) and posterior wall isolation with complex fractionated atrial electrogram ablation (persistent and longstanding persistent AF) were the end points at the time of the index procedure and for repeat procedures during the first year of follow-up. In case of recurrent arrhythmia >1 year, high-dose isoproterenol challenge was used to disclose non-PV trigger sites. During the first year, the success rate reached 91% (mean of 1.6 procedures). After a median follow-up of 42 months (range, 38–48 months), 49% of the patients remained free from AF/atrial tachycardia. All patients ...