Effect of transcoronary ablation of septal hypertrophy on clinical outcome in hypertrophic obstructive cardiomyopathy associated with atrial fibrillation

被引:8
作者
Obergassel, L
Lawrenz, T
Gietzen, FH
Lieder, F
Leuner, C
Kuhn, H
Stellbrink, C
机构
[1] Stadt Kliniken Bielefeld, Klin Kardiol & Internist Intensivmed, D-33604 Bielefeld, Germany
[2] Ctr Cardiovasc Med, Dept Cardiol, Bad Neustadt an der Saale, Saale, Germany
[3] Univ Munster, Acad Teaching Hosp, Dept Cardiol & Internal Intens Med, Bielefeld Community Hosp, Bielefeld, Germany
关键词
hypertrophic obstructive cardiomyopathy; atrial fibrillation; transcoronary alcohol ablation of septal hypertrophy;
D O I
10.1007/s00392-006-0372-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Relatively few reports on the clinical impact of atrial fibrillation (AF) in hypertrophic obstructive cardiomyopathy (HOCM) are available. The aims of our study are to report the effect of transcoronary ablation of septal hypertrophy (TASH) on clinical outcome in HOCM associated with AF and to evaluate the influence of AF on symptoms and quality of life in HOCM. Patient and methods In 80 consecutive patients (38 f, mean age 56 +/- 17 years) with severely symptomatic HOCM referred for interventional treatment, we analyzed the prevalence of AF based on 240 Holter ECG recordings and patients' history, retrospectively. Symptoms, quality of life, number of hospital admissions and hemodynamic performance were obtained in all patients before and after TASH. Mortality was additionally investigated by letter and telephone contact. Results The overall prevalence of AF was 29%. Paroxysmal AF was detected in 17 pts (21.3%), persistent AF in 5 pts (6.3%). Only 1 pt (1.3%) suffered from permanent AF. Symptoms due to AF were present in 52.6% of the AF patients. Quality of life score was markedly improved after TASH (15.9 +/- 3.8 vs. 20.7 +/- 3.8, p < 0.001) with no difference between sinus rhythm and atrial fibrillation. However, hospital admissions were more frequent in the AF group (0.85 +/- 1.84 vs. 0.28 +/- 0.81, p = 0.03) in 32 +/- 13 months. AF patients suffered more often from syncope before TASH (30 +/- 70% vs. 10 +/- 30%, p = 0.008). Two patients with sinus rhythm at baseline died after 32 +/- 13 months from cardiovascular cause. Conclusions Atrial fibrillation is the major cardiac arrhythmia in severe HOCM. The majority of AF patients demonstrate AF specific symptoms. The paroxysmal type of atrial fibrillation dominates by far. Both patients with and without atrial fibrillation showed similar quality of life with marked improvement after TASH.
引用
收藏
页码:254 / 260
页数:7
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