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Published in: Heart and Vessels 3/2019

01-03-2019 | Original Article

Long-term clinical course after catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy

Authors: Satoshi Higuchi, Koichiro Ejima, Yuichiro Minami, Kenjiro Ooyabu, Yuji Iwanami, Daigo Yagishita, Morio Shoda, Nobuhisa Hagiwara

Published in: Heart and Vessels | Issue 3/2019

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Abstract

Atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) patients is highly associated with deterioration of their clinical condition, such as worsening heart failure symptoms, and an increased thromboembolic stroke risk and cardiac mortality rate. This study aimed to investigate the long-term clinical course after catheter ablation (CA) in HCM patients with AF. Among 566 primary HCM patients at our institution, 94 who underwent rhythm control therapy to manage AF from 2002 to 2016 were retrospectively analyzed. The eligible patients were divided into two groups: those who managed AF with CA (n = 34) and those without CA (n = 60). The endpoints were the incidence of initial clinical events, including HCM-related death or an unplanned heart failure hospitalization, or new-onset thromboembolic strokes. During a mean follow-up of 5.8 years, 6% in the CA group and 28% in the non-CA group had a progression of the AF type into permanent AF (Log-rank: p = 0.012). In the Kaplan-Meyer curve analyses, the incidence of clinical events was significantly lower in the CA group than non-CA group (p = 0.025). The annual rates for the incidence of clinical events were 1.2% in the CA group and 6.7% in the non-CA group. In a Cox multivariate analysis, CA therapy (adjusted hazard ratio 0.22; 95% confidence interval: 0.05–0.97; p = 0.046) was the only independent predictor of the incidence of clinical events. In conclusion, CA may be associated with a favorable long-term clinical course in HCM patients with AF.
Literature
1.
go back to reference Masri A, Kanj M, Thamilarasan M, Wazni O, Smedira NG, Lever HM, Desai MY (2017) Outcomes in hypertrophic cardiomyopathy patients with and without atrial fibrillation: a survival meta-analysis. Cardiovasc Diagn Ther 7:36–44CrossRefPubMedPubMedCentral Masri A, Kanj M, Thamilarasan M, Wazni O, Smedira NG, Lever HM, Desai MY (2017) Outcomes in hypertrophic cardiomyopathy patients with and without atrial fibrillation: a survival meta-analysis. Cardiovasc Diagn Ther 7:36–44CrossRefPubMedPubMedCentral
2.
go back to reference Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ (2001) Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation 104:2517–2524CrossRefPubMed Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ (2001) Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation 104:2517–2524CrossRefPubMed
3.
go back to reference Rowin EJ, Hausvater A, Link MS, Abt P, Gionfriddo W, Wang W, Rastegar H, Estes NAM 3rd, Maron MS, Maron BJ (2017) Clinical profile and consequences of atrial fibrillation in hypertrophic cardiomyopathy. Circulation 136:2420–2436CrossRefPubMed Rowin EJ, Hausvater A, Link MS, Abt P, Gionfriddo W, Wang W, Rastegar H, Estes NAM 3rd, Maron MS, Maron BJ (2017) Clinical profile and consequences of atrial fibrillation in hypertrophic cardiomyopathy. Circulation 136:2420–2436CrossRefPubMed
4.
go back to reference Losi MA, Betocchi S, Grimaldi M, Spampinato N, Chiariello M (1994) Heterogeneity of left ventricular filling dynamics in hypertrophic cardiomyopathy. Am J Cardiol 73:987–990CrossRefPubMed Losi MA, Betocchi S, Grimaldi M, Spampinato N, Chiariello M (1994) Heterogeneity of left ventricular filling dynamics in hypertrophic cardiomyopathy. Am J Cardiol 73:987–990CrossRefPubMed
5.
go back to reference Siontis KC, Geske JB, Ong K, Nishimura RA, Ommen SR, Gersh BJ (2014) Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. J Am Heart Assoc 3:e001002CrossRefPubMedPubMedCentral Siontis KC, Geske JB, Ong K, Nishimura RA, Ommen SR, Gersh BJ (2014) Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. J Am Heart Assoc 3:e001002CrossRefPubMedPubMedCentral
6.
go back to reference Yashiro B, Minami Y, Terajima Y, Hagiwara N (2014) Prognostic difference between paroxysmal and non-paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy. J Cardiol 63:432–437CrossRefPubMed Yashiro B, Minami Y, Terajima Y, Hagiwara N (2014) Prognostic difference between paroxysmal and non-paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy. J Cardiol 63:432–437CrossRefPubMed
7.
go back to reference Maron MS, Rowin EJ, Olivotto I, Casey SA, Arretini A, Tomberli B, Garberich RF, Link MS, Chan RH, Lesser JR, Maron BJ (2016) Contemporary natural history and management of nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 67:1399–1409CrossRefPubMed Maron MS, Rowin EJ, Olivotto I, Casey SA, Arretini A, Tomberli B, Garberich RF, Link MS, Chan RH, Lesser JR, Maron BJ (2016) Contemporary natural history and management of nonobstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 67:1399–1409CrossRefPubMed
8.
go back to reference Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS (2014) Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol 64:83–99CrossRefPubMed Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS (2014) Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol 64:83–99CrossRefPubMed
9.
go back to reference Rowin EJ, Maron BJ, Kiernan MS, Casey SA, Feldman DS, Hryniewicz KM, Chan RH, Harris KM, Udelson JE, DeNofrio D, Roberts WC, Maron MS (2014) Advanced heart failure with preserved systolic function in nonobstructive hypertrophic cardiomyopathy: underrecognized subset of candidates for heart transplant. Circ Heart Fail 7:967–975CrossRefPubMed Rowin EJ, Maron BJ, Kiernan MS, Casey SA, Feldman DS, Hryniewicz KM, Chan RH, Harris KM, Udelson JE, DeNofrio D, Roberts WC, Maron MS (2014) Advanced heart failure with preserved systolic function in nonobstructive hypertrophic cardiomyopathy: underrecognized subset of candidates for heart transplant. Circ Heart Fail 7:967–975CrossRefPubMed
10.
go back to reference Pasqualucci D, Fornaro A, Castelli G, Rossi A, Arretini A, Chiriatti C, Targetti M, Girolami F, Corda M, Orrù P, Matta G, Stefàno P, Cecchi F, Porcu M, Olivotto I (2015) clinical spectrum, therapeutic options, and outcome of advanced heart failure in hypertrophic cardiomyopathy. Circ Heart Fail 8:1014–1021CrossRefPubMed Pasqualucci D, Fornaro A, Castelli G, Rossi A, Arretini A, Chiriatti C, Targetti M, Girolami F, Corda M, Orrù P, Matta G, Stefàno P, Cecchi F, Porcu M, Olivotto I (2015) clinical spectrum, therapeutic options, and outcome of advanced heart failure in hypertrophic cardiomyopathy. Circ Heart Fail 8:1014–1021CrossRefPubMed
11.
go back to reference Haruki S, Minami Y, Hagiwara N (2016) Stroke and embolic events in hypertrophic cardiomyopathy: risk stratification in patients without atrial fibrillation. Stroke 47:936–942CrossRefPubMed Haruki S, Minami Y, Hagiwara N (2016) Stroke and embolic events in hypertrophic cardiomyopathy: risk stratification in patients without atrial fibrillation. Stroke 47:936–942CrossRefPubMed
12.
go back to reference Guttmann OP, Pavlou M, O'Mahony C, Monserrat L, Anastasakis A, Rapezzi C, Biagini E, Gimeno JR, Limongelli G, Garcia-Pavia P, McKenna WJ, Omar RZ, Elliott PM (2015) Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy (HCM risk-CVA). Eur J Heart Fail 17:837–845CrossRefPubMed Guttmann OP, Pavlou M, O'Mahony C, Monserrat L, Anastasakis A, Rapezzi C, Biagini E, Gimeno JR, Limongelli G, Garcia-Pavia P, McKenna WJ, Omar RZ, Elliott PM (2015) Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy (HCM risk-CVA). Eur J Heart Fail 17:837–845CrossRefPubMed
13.
go back to reference Guttmann OP, Rahman MS, O'Mahony C, Anastasakis A, Elliott PM (2014) Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart 100:465–472CrossRefPubMed Guttmann OP, Rahman MS, O'Mahony C, Anastasakis A, Elliott PM (2014) Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart 100:465–472CrossRefPubMed
14.
go back to reference Maron BJ, Olivotto I, Bellone P, Conte MR, Cecchi F, Flygenring BP, Casey SA, Gohman TE, Bongioanni S, Spirito P (2002) Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 39:301–307CrossRefPubMed Maron BJ, Olivotto I, Bellone P, Conte MR, Cecchi F, Flygenring BP, Casey SA, Gohman TE, Bongioanni S, Spirito P (2002) Clinical profile of stroke in 900 patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 39:301–307CrossRefPubMed
15.
go back to reference Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2379CrossRefPubMed Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2379CrossRefPubMed
16.
go back to reference Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011) American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; American Society of Echocardiography; American Society of Nuclear Cardiology; Heart Failure Society of America; Heart Rhythm Society; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons. 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. Circulation 124:e783–831PubMed Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011) American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; American Society of Echocardiography; American Society of Nuclear Cardiology; Heart Failure Society of America; Heart Rhythm Society; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons. 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. Circulation 124:e783–831PubMed
17.
go back to reference Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37:2893–2962CrossRefPubMed Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, Van Putte B, Vardas P (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37:2893–2962CrossRefPubMed
18.
go back to reference Zhao DS, Shen Y, Zhang Q, Lin G, Lu YH, Chen BT, Shi LS, Huang JF, Lu HH (2016) Outcomes of catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy: a systematic review and meta-analysis. Europace 18:508–520CrossRefPubMed Zhao DS, Shen Y, Zhang Q, Lin G, Lu YH, Chen BT, Shi LS, Huang JF, Lu HH (2016) Outcomes of catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy: a systematic review and meta-analysis. Europace 18:508–520CrossRefPubMed
19.
go back to reference Providencia R, Elliott P, Patel K, McCready J, Babu G, Srinivasan N, Bronis K, Papageorgiou N, Chow A, Rowland E, Lowe M, Segal OR, Lambiase PD (2016) Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis. Heart 102:1533–1543CrossRefPubMed Providencia R, Elliott P, Patel K, McCready J, Babu G, Srinivasan N, Bronis K, Papageorgiou N, Chow A, Rowland E, Lowe M, Segal OR, Lambiase PD (2016) Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis. Heart 102:1533–1543CrossRefPubMed
20.
go back to reference 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 12:1438–1447CrossRefPubMed 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 12:1438–1447CrossRefPubMed
21.
go back to reference Santangeli P, Di Biase L, Themistoclakis S, Raviele A, Schweikert RA, Lakkireddy D, Mohanty P, Bai R, Mohanty S, Pump A, Beheiry S, Hongo R, Sanchez JE, Gallinghouse GJ, Horton R, Dello Russo A, Casella M, Fassini G, Elayi CS, Burkhardt JD, Tondo C, Natale A (2013) Catheter ablation of atrial fibrillation in hypertrophic cardiomyopathy: long-term outcomes and mechanisms of arrhythmia recurrence. Circ Arrhythm Electrophysiol 6:1089–1094CrossRefPubMed Santangeli P, Di Biase L, Themistoclakis S, Raviele A, Schweikert RA, Lakkireddy D, Mohanty P, Bai R, Mohanty S, Pump A, Beheiry S, Hongo R, Sanchez JE, Gallinghouse GJ, Horton R, Dello Russo A, Casella M, Fassini G, Elayi CS, Burkhardt JD, Tondo C, Natale A (2013) Catheter ablation of atrial fibrillation in hypertrophic cardiomyopathy: long-term outcomes and mechanisms of arrhythmia recurrence. Circ Arrhythm Electrophysiol 6:1089–1094CrossRefPubMed
22.
go back to reference Eriksson MJ, Sonnenberg B, Woo A, Rakowski P, Parker TG, Wigle ED, Rakowski H (2002) Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol 39:638–645CrossRefPubMed Eriksson MJ, Sonnenberg B, Woo A, Rakowski P, Parker TG, Wigle ED, Rakowski H (2002) Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol 39:638–645CrossRefPubMed
23.
go back to reference Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Davies DW, Day JD, d'Avila A, de Groot NMSN, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T (2017) 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 14:e275–e444CrossRefPubMedPubMedCentral Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Davies DW, Day JD, d'Avila A, de Groot NMSN, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T (2017) 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 14:e275–e444CrossRefPubMedPubMedCentral
24.
go back to reference Ejima K, Henmi R, Iwanami Y, Yagishita D, Shoda M, Hagiwara N (2017) Comparison of the efficacy of empiric thoracic vein isolation for the treatment of paroxysmal and persistent atrial fibrillation in patients without structural heart disease. J Cardiovasc Electrophysiol 28:266–272CrossRefPubMed Ejima K, Henmi R, Iwanami Y, Yagishita D, Shoda M, Hagiwara N (2017) Comparison of the efficacy of empiric thoracic vein isolation for the treatment of paroxysmal and persistent atrial fibrillation in patients without structural heart disease. J Cardiovasc Electrophysiol 28:266–272CrossRefPubMed
25.
go back to reference Varnava AM, Elliott PM, Sharma S, McKenna WJ, Davies MJ (2000) Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. Heart 84:476–482CrossRefPubMedPubMedCentral Varnava AM, Elliott PM, Sharma S, McKenna WJ, Davies MJ (2000) Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. Heart 84:476–482CrossRefPubMedPubMedCentral
26.
go back to reference Petersen SE, Jerosch-Herold M, Hudsmith LE, Robson MD, Francis JM, Doll HA, Selvanayagam JB, Neubauer S, Watkins H (2007) Evidence for microvascular dysfunction in hypertrophic cardiomyopathy: new insights from multiparametric magnetic resonance imaging. Circulation 115:2418–2425CrossRefPubMed Petersen SE, Jerosch-Herold M, Hudsmith LE, Robson MD, Francis JM, Doll HA, Selvanayagam JB, Neubauer S, Watkins H (2007) Evidence for microvascular dysfunction in hypertrophic cardiomyopathy: new insights from multiparametric magnetic resonance imaging. Circulation 115:2418–2425CrossRefPubMed
27.
go back to reference Stafford WJ, Trohman RG, Bilsker M, Zaman L, Castellanos A, Myerburg RJ (1986) Cardiac arrest in an adolescent with atrial fibrillation and hypertrophic cardiomyopathy. J Am Coll Cardiol 7:701–704CrossRefPubMed Stafford WJ, Trohman RG, Bilsker M, Zaman L, Castellanos A, Myerburg RJ (1986) Cardiac arrest in an adolescent with atrial fibrillation and hypertrophic cardiomyopathy. J Am Coll Cardiol 7:701–704CrossRefPubMed
28.
go back to reference Basso C, Thiene G, Corrado D, Buja G, Melacini P, Nava A (2000) Hypertrophic cardiomyopathy and sudden death in the young: pathologic evidence of myocardial ischemia. Hum Pathol 31:988–998CrossRefPubMed Basso C, Thiene G, Corrado D, Buja G, Melacini P, Nava A (2000) Hypertrophic cardiomyopathy and sudden death in the young: pathologic evidence of myocardial ischemia. Hum Pathol 31:988–998CrossRefPubMed
29.
go back to reference Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL, Josephson RA, Kellen JC, Klein RC, Krahn AD, Mickel M, Mitchell LB, Nelson JD, Rosenberg Y, Schron E, Shemanski L, Waldo AL, Wyse DG, Investigators AFFIRM (2004) Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation 109:1509–1513CrossRefPubMed Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL, Josephson RA, Kellen JC, Klein RC, Krahn AD, Mickel M, Mitchell LB, Nelson JD, Rosenberg Y, Schron E, Shemanski L, Waldo AL, Wyse DG, Investigators AFFIRM (2004) Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation 109:1509–1513CrossRefPubMed
Metadata
Title
Long-term clinical course after catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy
Authors
Satoshi Higuchi
Koichiro Ejima
Yuichiro Minami
Kenjiro Ooyabu
Yuji Iwanami
Daigo Yagishita
Morio Shoda
Nobuhisa Hagiwara
Publication date
01-03-2019
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 3/2019
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-018-1269-3

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