Introduction
Atrial fibrillation (AF) is a common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). Prognostic value of AF in HCM patients is not clear and various studies report equivocal results. The aim of our study was to determine whether AF is a risk factor for mortality and morbidity in the HCM patients.
Methods
Total of 505 patients diagnosed with HCM between 1998 and 2022 in a tertiary cardiovascular centre were included in the study. The occurrence of AF, stroke, and death were analyzed and survival analysis using Kaplan-Meier method was performed.
Results
AF was diagnosed in 146 (29 %) HCM patients. Patients with AF were significantly older at the initial visit (57.3±13.6 vs. 51.6±15.7 years, p<0.001) and had longer follow-up (10.6±6.8 vs. 7.9±6.0 years, p<0.001) than patients without AF. All-cause mortality (30.8 % vs. 16.4 %, p<0.001), HCM-related death (10.3 % vs. 3.3 %, p<0.01), and the incidence of stroke (15.1 % vs. 6.7 %, p<0.01), was more frequent in the AF cohort than in patients without AF. Survival analysis showed no statistically significant difference in overall survival (Figure 1) and the probability of stroke in patients with or without AF.
Conclusion
Patients with AF had lower survival and died more often from HCM-related causes than the patients without AF. However, the majority of HCM patients died from non-HCM-related causes. Although the incidence of strokes and mortality was higher in patients with AF, the difference was not statistically significant in survival analysis, probably due to different length of follow-up, overall low number of events, and limited size of our cohort.
