Abstract
Introduction:
Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM). Radiofrequency transcatheter ablation (RFCA) for AF in patients with HCM is beneficial, however, its efficacy and safety is not well characterized. This meta-analysis aimed to access the efficacy of RFCA in patients with HCM and concomitant AF.
Methods:
PubMed, Embase, Cochrane, ClinicalTrials.gov, and Google Scholar were searched for studies evaluating the efficacy of RFCA for AF in patients with HCM from January 1, 2000, until April 2021. The outcomes data regarding the efficacy of RFCA after a single or multiple procedures was assessed. The analysis was performed using a random-effects-model using the Mantel-Haenszel method and results presented as 95% confidence interval using STATA version 15.1 software.
Results:
Sixteen observational (N=769) studies were included. The mean time after the first procedure was ≥12 months and the meantime after multiple procedures was 3 years. The mean age was 57.5+/-8.3 years and 30% of patients were women. Single-procedure freedom
from AF at the latest follow-up was 38.67% (95% CI: 33.38-44.10%, I2 =54.55%) reported by 15/16 studies (Fig 1A). With multiple procedures, the final success rate was 45.648% (95% CI: 37.52-53.90, I2=75.9%) reported by 15/16 studies (Fig 1B)
Conclusions:
RFCA of AF in patients with HCM appears to be safe and feasible, although these patients have lower overall success rates compared to a more typical AF ablation population. HCM patients also require multiple procedures to gain intermediate success rates.