1. Department of Cardiology, Rhythmology and Internal Intensive Care, Klinikum Köln-Merheim, University Witten-Herdecke, Ostmerheimer Str. 200, 51109 Cologne, Germany
2. Department of Cardiology and Angiology, Johanniter-Krankenhaus Rheinhausen GmbH, Kreuzacker 1-7, 47228 Duisburg, Germany
3. Department of Diagnostic and Interventional Radiology, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany;
4. Ruhr-University Bochum, Faculty of Medicine, Universitätsstraße 150, 448801 Bochum, Germany
Background: Atrial fibrillation (AF) represents a turning point in hypertrophic cardiomyopathy (HCM). Pulmonary Vein Isolation (PVI) with Radiofrequency Catheter Ablation (RFCA) is accepted to be successful in restoring sinus rhythm (SR) in HCM patients. The efficacy of cryoballoon (CB) therapy in HCM patients has not been studied so far.
Methods: 166 patients with AF underwent PVI with CB technology in our single center between 1/2012 and 12/2015. To evaluate the efficacy of the CB therapy in HCM patients, we compared their clinical outcome with those in “Non-HCM” AF patients in a 3 and 6 months follow-up.
Results: Out of 166 AF patients (65.7% paroxysmal AF, PAF), 4 patients had HCM and PAF (young males < 50 years). During the blanking period, 26 patients (15.8%) suffered from AF recurrence (11.0% PAF), including all HCM patients. The 6 months follow up of “Non-HCM” AF patients showed acceptable results (80% stable SR), whereas the HCM patients remained AF.
In Conclusion: Even if the CB provides advantages, the single device cannot be recommended in HCM patients because of early AF recurrences. Anyway, because of the specific hemodynamic changes in HCM patients with AF, ablation should be sought in an early state of its occurrence, then, however, preferably with RFCA.
Keywords: cryoballoon ablation, hypertrophic cardiomyopathy, atrial fibrillation, follow up