| Subject: there is no clinical study which analyzes the capability of catheter ablation to eliminate atrial fibrillation(AF)in high sudden cardiac death(SCD)risk hypertrophic cardiomyopathy(HCM)patients.Our study was designed to investigate the clinical effectiveness of catheter radiofrequency ablation for AF of HCM Patients and its relationship to SCD risk.Methods: we selected 62 patients with symptomatic AF and confirmed HCM who underwent radiofrequency catheter ablations and 124 AF type?age?gender and left atrial dimension-matched AF patients without cardiomyopathies,compared the effectiveness and safety of AF catheter ablation.Then the risk of SCD was calculated by HCM Risk-SCD equation.The patients with 5-year SCD risk higher than 0.04 were assigned to group A(n=15)and the others were assigned to group B(n=47).Results: Mean follow-up period was 47.2±30.4 months.Patients with symptomatic AF and confirmed HCM had significantly poorer outcomes than those without cardiomyopathies after both first ablations(45.2% vs.59.7%,p=0.06)and repeat ablations(54.8% vs.70.2%,p=0.039).The rates of peri-operative complications and deaths between two groups had no statistical difference.Patients in group A had significantly poorer outcomes than those in group B after both first ablations(26.7% vs.51.1%,p=0.098)and repeat ablations(33.3% vs.61.7%,p=0.055).5-year risk of SCD(OR:1.168,95%CI:1.012-1.348;p=0.034)can also predict AF/atrial flutter/atrial tachycardia after catheter ablations.Conclusions:Patients with symptomatic AF and confirmed HCM had significantly poorer outcomes than those without structural heart disease after both first ablations and repeat ablations.Radiofrequency AF catheter ablations in patients of group A had a worse efficacy than Group B after both first ablations and repeat ablations.5-year risk of SCD can predict arrhythmic recurrence of AF ablation in HCM patients. |
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