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Journal of Interventional Cardiac Electrophysiology

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01-11-2015 | REVIEWS

Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy patients: a systematic review

Authors: Hakeem S. K. Ha, Nelson Wang, Sophia Wong, Steven Phan, Jace Liao, Narendra Kumar, Pierre Qian, Tristan D. Yan, Kevin Phan

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2015

Abstract

Purpose

The primary aim of this systematic review was to assess the efficacy of catheter ablation of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). Differentiation based off catheter ablation modalities was not considered due to the limited scope of the current field. Studies that employed alcohol septal ablation for the treatment of AF in HCM patients were excluded as were abstracts, case reports, conference presentations, editorials, reviews, and expert opinions

Methods

Electronic searches were performed in six databases from their inception until January 2014. Relevant studies regarding catheter ablation for AF in HCM populations were identified. Data was extracted and analyzed according to pre-defined clinical endpoints

Results

A review was undertaken of eight studies in which 241 HCM patients underwent catheter ablation for AF. Overall AF-free survival at last follow-up ranged from 47 to 77 % (64–67 %). Sinus rhythm was maintained at last follow-up in 47–82 % (median 64–67 %). AF recurrence ranged from 0 to 66 % (median 35–40 %).

Conclusion

A review of the current evidence suggests that catheter ablation of AF in HCM patients is effective with suitable efficacy and is justified in select patients. Future adequately powered randomized studies should be undertaken aimed at addressing long-term efficacy and complications associated with procedural outcomes.

Maron, B. J. (1997). Hypertrophic cardiomyopathy. Lancet, 350(9071), 127–133.CrossRefPubMed

Liu, X., Ouyang, F., Mavrakis, H., Ma, C., Dong, J., Ernst, S., et al. (2005). Complete pulmonary vein isolation guided by three-dimensional electroanatomical mapping for the treatment of paroxysmal atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy. Europace, 7(5), 421–427.CrossRefPubMed

Spirito, P., Seidman, C. E., McKenna, W. J., & Maron, B. J. (1997). The management of hypertrophic cardiomyopathy. New England Journal of Medicine, 336(11), 775–785.CrossRefPubMed

Maron, B. J., Olivotto, I., Bellone, P., Conte, M. R., Cecchi, F., Flygenring, B. P., et al. (2002). Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. Journal of the American College of Cardiology, 39(2), 301–307.CrossRefPubMed

Olivotto, I., Cecchi, F., Casey, S. A., Dolara, A., Traverse, J. H., & Maron, B. J. (2001). Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation, 104(21), 2517–2524.CrossRefPubMed

Wolf, P. A., Abbott, R. D., & Kannel, W. B. (1991). Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke, 22(8), 983–988.CrossRefPubMed

McKenna, W. J., & Behr, E. R. (2002). Hypertrophic cardiomyopathy: management, risk stratification, and prevention of sudden death. Heart, 87(2), 169–176.CrossRefPubMedCentralPubMed

Gaita, F., Di Donna, P., Olivotto, I., Scaglione, M., Ferrero, I., Montefusco, A., et al. (2007). Usefulness and safety of transcatheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy. American Journal of Cardiology, 99(11), 1575–1581.CrossRefPubMed

Kilicaslan, F., Verma, A., Saad, E., Themistoclakis, S., Bonso, A., Raviele, A., et al. (2006). Efficacy of catheter ablation of atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy. Heart Rhythm, 3(3), 275–280.CrossRefPubMed

10.

Manolis, A. G., Katsivas, A. G., Lazaris, E. E., Vassilopoulos, C. V., & Louvros, N. E. (1998). Ventricular performance and quality of life in patients who underwent radiofrequency AV junction ablation and permanent pacemaker implantation due to medically refractory atrial tachyarrhythmias. Journal of Interventional Cardiac Electrophysiology, 2(1), 71–76.CrossRefPubMed

11.

Chen, M. S., Marrouche, N. F., Khaykin, Y., Gillinov, A. M., Wazni, O., Martin, D. O., et al. (2004). Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. Journal of the American College of Cardiology, 43(6), 1004–1009.CrossRefPubMed

12.

Marrouche, N. F., Martin, D. O., Wazni, O., Gillinov, A. M., Klein, A., Bhargava, M., et al. (2003). Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications. Circulation, 107(21), 2710–2716.CrossRefPubMed

13.

Bhargava, M., Marrouche, N. F., Martin, D. O., Schweikert, R. A., Saliba, W., Saad, E. B., et al. (2004). Impact of age on the outcome of pulmonary vein isolation for atrial fibrillation using circular mapping technique and cooled-tip ablation catheter. Journal of Cardiovascular Electrophysiology, 15(1), 8–13.CrossRefPubMed

14.

Khaykin, Y., Marrouche, N. F., Saliba, W., Schweikert, R., Bash, D., Chen, M. S., et al. (2004). Pulmonary vein antrum isolation for treatment of atrial fibrillation in patients with valvular heart disease or prior open heart surgery. Heart Rhythm, 1(1), 33–39.CrossRefPubMed

15.

Di Donna, P., Olivotto, I., Delcre, S. D., Caponi, D., Scaglione, M., Nault, I., et al. (2010). Efficacy of catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: impact of age, atrial remodelling, and disease progression. Europace, 12(3), 347–355.CrossRefPubMed

16.

Hayashi, H., Hayashi, M., Miyauchi, Y., Takahashi, K., Uetake, S., Tsuboi, I., et al. (2014). Left atrial wall thickness and outcomes of catheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy. Journal of Interventional Cardiac Electrophysiology, 40(2), 153–160.CrossRefPubMed

17.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The, P. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6(7), e1000097.CrossRefPubMedCentralPubMed

18.

Stroup, D. F., Berlin, J. A., Morton, S. C., Olkin, I., Williamson, G. D., Rennie, D., et al. (2000). Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA, 283(15), 2008–2012.CrossRefPubMed

19.

Bunch, T. J., Munger, T. M., Friedman, P. A., Asirvatham, S. J., Brady, P. A., Cha, Y. M., et al. (2008). Substrate and procedural predictors of outcomes after catheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy. Journal of Cardiovascular Electrophysiology, 19(10), 1009–1014.CrossRefPubMed

20.

Derejko, P., Polanska, M., Chojnowska, L., Michalowska, I., Wojcik, A., Piotrowicz, E., et al. (2013). Catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy: atrial fibrillation type determines the success rate. Kardiologia Polska, 71(1), 17–24.PubMed

21.

Santangeli, P., Di Biase, L., Themistoclakis, S., Raviele, A., Schweikert, R. A., Lakkireddy, D., et al. (2013). Catheter ablation of atrial fibrillation in hypertrophic cardiomyopathy: long-term outcomes and mechanisms of arrhythmia recurrence. Circulation. Arrhythmia and Electrophysiology, 6(6), 1089–1094.CrossRefPubMed

22.

(2003) Maintenance of sinus rhythm in patients with atrial fibrillation: an AFFIRM substudy of the first antiarrhythmic drug. Journal of the American College of Cardiology, 42(1), 20–29.

23.

Robinson, K., Frenneaux, M. P., Stockins, B., Karatasakis, G., Poloniecki, J. D., & McKenna, W. J. (1990). Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study. Journal of the American College of Cardiology, 15(6), 1279–1285.CrossRefPubMed

24.

Cappato, R., Calkins, H., Chen, S. A., Davies, W., Iesaka, Y., Kalman, J., et al. (2010). Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation. Arrhythmia and Electrophysiology, 3(1), 32–38.CrossRefPubMed

25.

Cha, Y.-M., Munger, T. M., Asirvatham, S. J., Friedman, P. A., Monahan, K. H., & Packer, D. L. Impact of left atrial size on the outcome of wide area circumferential ablation vs lasso-guided pulmonary vein isolation. Heart Rhythm, 2(5), S192.

26.

Hsu, L. F., Jais, P., Sanders, P., Garrigue, S., Hocini, M., Sacher, F., et al. (2004). Catheter ablation for atrial fibrillation in congestive heart failure. New England Journal of Medicine, 351(23), 2373–2383.CrossRefPubMed

27.

Lang, C. C., Santinelli, V., Augello, G., Ferro, A., Gugliotta, F., Gulletta, S., et al. (2005). Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral valve prostheses and enlarged atria: safety, feasibility, and efficacy. Journal of the American College of Cardiology, 45(6), 868–872.CrossRefPubMed

28.

Ganesan, A. N., Shipp, N. J., Brooks, A. G., Kuklik, P., Lau, D. H., Lim, H. S., et al. (2013). Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis. Journal of the American Heart Association, 2(2), e004549.CrossRefPubMedCentralPubMed

29.

Cannon, R. O., 3rd, Rosing, D. R., Maron, B. J., Leon, M. B., Bonow, R. O., Watson, R. M., et al. (1985). Myocardial ischemia in patients with hypertrophic cardiomyopathy: contribution of inadequate vasodilator reserve and elevated left ventricular filling pressures. Circulation, 71(2), 234–243.CrossRefPubMed

30.

Dilsizian, V., Bonow, R. O., Epstein, S. E., & Fananapazir, L. (1993). Myocardial ischemia detected by thallium scintigraphy is frequently related to cardiac arrest and syncope in young patients with hypertrophic cardiomyopathy. Journal of the American College of Cardiology, 22(3), 796–804.CrossRefPubMed

31.

Boriani, G., Rapezzi, C., Biffi, M., Branzi, A., & Spirito, P. (2002). Atrial fibrillation precipitating sustained ventricular tachycardia in hypertrophic cardiomyopathy. Journal of Cardiovascular Electrophysiology, 13(9), 954.CrossRefPubMed

32.

Chun, S. H., Sager, P. T., Stevenson, W. G., Nademanee, K., Middlekauff, H. R., & Singh, B. N. (1995). Long-term efficacy of amiodarone for the maintenance of normal sinus rhythm in patients with refractory atrial fibrillation or flutter. American Journal of Cardiology, 76(1), 47–50.CrossRefPubMed

33.

Chen, M. S., McCarthy, P. M., Lever, H. M., Smedira, N. G., & Lytle, B. L. (2004). Effectiveness of atrial fibrillation surgery in patients with hypertrophic cardiomyopathy. American Journal of Cardiology, 93(3), 373–375.CrossRefPubMed

34.

Gersh, B. J., Maron, B. J., Bonow, R. O., Dearani, J. A., Fifer, M. A., Link, M. S., et al. (2011). 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of Thoracic and Cardiovascular Surgery, 142(6), e153–e203.CrossRefPubMed

35.

Ommen, S. R., Maron, B. J., Olivotto, I., Maron, M. S., Cecchi, F., Betocchi, S., et al. (2005). Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy. Journal of the American College of Cardiology, 46(3), 470–476.CrossRefPubMed

36.

Kearney, K., Stephenson, R., Phan, K., Chan, W. Y., Huang, M. Y., & Yan, T. D. (2014). A systematic review of surgical ablation versus catheter ablation for atrial fibrillation. Annual of Cardiothoracic Surgery, 3(1), 15–29.

37.

Phan, K., Phan, S., Thiagalingam, A., Medi, C., & Yan, T. D. (2015). Thoracoscopic surgical ablation versus catheter ablation for atrial fibrillation. European Journal of Cardio-Thoracic Surgery.

38.

Riedlbauchova, L., Janousek, J., & Veselka, J. (2013). Ablation of hypertrophic septum using radiofrequency energy: an alternative for gradient reduction in patient with hypertrophic obstructive cardiomyopathy? Journal of Invasive Cardiology, 25(6), E128–E132.PubMed

39.

Santangeli, P., Di Biase, L., Lakkireddy, D., Burkhardt, J. D., Pillarisetti, J., Michowitz, Y., et al. (2010). Radiofrequency catheter ablation of ventricular arrhythmias in patients with hypertrophic cardiomyopathy: safety and feasibility. Heart Rhythm, 7(8), 1036–1042.CrossRefPubMed

40.

Calkins, H., Epstein, A., Packer, D., Arria, A. M., Hummel, J., Gilligan, D. M., et al. (2000). Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study. Cooled RF Multi Center Investigators Group. Journal of the American College of Cardiology, 35(7), 1905–1914.CrossRefPubMed

41.

Yokoyama, K., Nakagawa, H., Wittkampf, F. H., Pitha, J. V., Lazzara, R., & Jackman, W. M. (2006). Comparison of electrode cooling between internal and open irrigation in radiofrequency ablation lesion depth and incidence of thrombus and steam pop. Circulation, 113(1), 11–19.CrossRefPubMed

42.

Phan, K., Tian, D. H., Cao, C., Black, D., & Yan, T. D. (2015). Systematic review and meta-analysis: techniques and a guide for the academic surgeon. Annual of Cardiothoracic Surgery, 4(2), 112–122.

Title: Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy patients: a systematic review
Authors: Hakeem S. K. Ha
Nelson Wang
Sophia Wong
Steven Phan
Jace Liao
Narendra Kumar
Pierre Qian
Tristan D. Yan
Kevin Phan
Publication date: 01-11-2015
Publisher: Springer US
Published in: Journal of Interventional Cardiac Electrophysiology / Issue 2/2015
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-015-0047-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy patients: a systematic review

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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