Clinical and echocardiographic parameters as risk factors for atrial fibrillation in patients with hypertrophic cardiomyopathy.

BACKGROUND: Atrial fibrillation (AF) is a common complication in patients with hypertrophic cardiomyopathy (HCM) and may contribute to high cardiovascular morbidity and mortality. Therefore, it is important to assess parameters associated with AF in HCM patients.

HYPOTHESIS: The aim of the study was to evaluate AF prevalence in patients with HCM and to investigate risk factors for AF.

METHODS: Five hundred and forty-six HCM patients aged below 65 were included into analysis. Clinical and echocardiographic parameters were analyzed.

RESULTS: In 141 patients (25.8%) AF episodes were recorded. The following factors were identified as risk factors for AF in patients with HCM: age ≥ 45 years (OR 2.38, CI 1.40-4.05, P = 0.001), past history of presyncope or syncope (OR 2.25, CI 1.35-3.74, P = 0.002), non-sustained ventricular tachycardia (nsVT) (OR 2.70, CI 1.60-4.57, P < 0.001), left atrium diameter during first assessment (OR 1.065, CI 1.03-1.11, P = 0.001), left atrium diameter at the last assessment before AF occurrence (OR 1.10, CI 1.06-1.14, P < 0.001) and left ventricular ejection fraction at the last assessment before AF occurrence (CI 0.96, CI 0.94-0.98, P = 0.001).

CONCLUSIONS: We confirm that AF is a common complication for patients with HCM. Identification of patients with high risk for AF and implementation of preventive strategies may reduce AF occurrence and its complications.