Hypertrophic cardiomyopathy (HCM) is associated with an increased risk of atrial fibrillation
(AF) and stroke, representing main causes of clinical deterioration, morbidity and
mortality [
[1]
]. It has been demonstrated that the incidence of ischemic stroke in HCM patients
with AF and no conventional risk factors is higher than in AF patients without HCM
but with CHA2DS2-VASc scores of 2 [
[2]
]. Indeed, both HCM and AF guidelines don't recommend using the CHA2DS2-VASc score
in HCM patients (due to a likely systematic underestimation of risk), while recommending
oral anticoagulation in all HCM patients with AF unless contraindicated and irrespective
of risk scores [
[3]
,
[4]
].- Hindricks G.
- Potpara T.
- Dagres N.
- et al.
2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed
in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS):
the task force for the diagnosis and management of atrial fibrillation of the European
Society of Cardiology (ESC) developed with the special contribution of the European
heart rhythm association (EHRA) of the ESC.
Eur. Heart J. 2021; 42: 373-498
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References
- Clinical profile and consequences of atrial fibrillation in hypertrophic cardiomyopathy.Circulation. 2017; 136: 2420-2436
- Hypertrophic cardiomyopathy in patients with atrial fibrillation: prevalence and associated stroke risks in a nationwide cohort study.Thromb. Haemost. 2019; 119: 285-293
- 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC).Eur. Heart J. 2014; 35: 2733-2779
- 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European heart rhythm association (EHRA) of the ESC.Eur. Heart J. 2021; 42: 373-498
- Development and validation of a clinical predictive model for identifying hypertrophic cardiomyopathy patients at risk for atrial fibrillation: the HCM-AF score.Circ. Arrhythm. Electrophysiol. 2021; 14e009796
- Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy (HCM risk-CVA).Eur. J. Heart Fail. 2015; 17: 837-845
- Incidence of stroke in patients with hypertrophic cardiomyopathy in stable sinus rhythm during long-term monitoring.Int. J. Cardiol. 2023; 381: 70-75
- Atrial dysfunction assessed by cardiac magnetic resonance as an early marker of Fabry cardiomyopathy.JACC Cardiovasc. Imaging. 2020; 13: 2262-2264
- Arterial thrombo-embolic events in cardiac amyloidosis: a look beyond atrial fibrillation.Amyloid. 2021; 28: 12-18
- Anatomical characteristics of the left atrium and left atrial appendage in relation to the risk of stroke in patients with versus without atrial fibrillation.Circ. Arrhythm. Electrophysiol. 2021; 14e009777
Article info
Publication history
Published online: May 25, 2023
Accepted:
May 22,
2023
Received:
May 18,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier B.V. All rights reserved.
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- Incidence of stroke in patients with hypertrophic cardiomyopathy in stable sinus rhythm during long-term monitoringInternational Journal of CardiologyVol. 381
- PreviewPatients with hypertrophic cardiomyopathy (HCM) are at increased risk of stroke, but the incidence and factors associated with cardioembolic events in HCM patients without atrial fibrillation (AF) remain unresolved. We determined the incidence of stroke in patients in sinus rhythm (SR) monitored with a cardiac implantable electronic device (CIED).
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