Eur Heart J Open. 2026 Mar 13;6(2):oeag046. doi: 10.1093/ehjopen/oeag046. eCollection 2026 Mar.
ABSTRACT
AIMS: Catheter ablation (CA) for atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM) poses unique challenges due to structural and electrical remodelling. This study examines AF recurrence and complication rates following CA in HCM patients compared to a matched AF non-HCM cohort.
METHODS AND RESULTS: A retrospective cohort study of Danish nationwide registries from 2010 to 2022 was conducted. Rates of AF recurrence, heart failure, ischaemic stroke, and death were analysed using propensity score matching and Cox regression models. Among 28 231 patients undergoing first-time CA for AF, 299 had a confirmed diagnosis of HCM. Patients with HCM demonstrated significantly higher rates of AF recurrence compared to a matched non-HCM cohort, with 40% experiencing recurrence vs. 30% in the non-HCM group after 1 year and 67% vs. 58% after 5 years [hazard ratio (HR) 1.41, P < 0.001]. Despite the elevated recurrence rates, no significant differences were observed in the incidence of ischaemic stroke (HR 0.99, P & 0.9) or all-cause mortality (HR 1.18, P & 0.3). However, the risk of heart failure was significantly increased (HR 2.45, P & <0.001).
CONCLUSION: HCM patients experience higher AF recurrence rates post-CA as well as a higher risk of heart failure. These findings highlight the need for tailored strategies to improve outcomes in this high-risk group.
PMID:41909630 | PMC:PMC13021360 | DOI:10.1093/ehjopen/oeag046