Prognostic Significance and Risk of Atrial Fibrillation of Wolff-Parkinson-White Syndrome in Patients With Hypertrophic Cardiomyopathy

Am J Cardiol. 2018 Nov 1;122(9):1546-1550. doi: 10.1016/j.amjcard.2018.07.021. Epub 2018 Aug 3.

Abstract

To assess the mid-term mortality and risk of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HC) and Wolff-Parkinson-White (WPW) syndrome, 40 patients with HC and WPW were enrolled in our center between 2010 and 2017. An age- and gender-matched comparison cohort of patients with HC without WPW (n = 160) was generated from the same center. The clinical profile and outcomes were assessed. Of 40 patients with WPW, 28 underwent accessory pathway (AP) elimination. Two patients (7%) had failed in AP elimination. During mid-term follow-up, 1 patient had an implantable cardioverter-defibrillator intervention. Fourteen patients had AF. A previous history of AF (hazard ratio [HR]: 4.69; 95% confidence interval [CI] 1.51 to 14.63) and left atrial dimension (HR: 1.12; 95% CI 1.03 to 1.23) at baseline were risk factors for AF occurrence during follow-up. The AP elimination significantly reduced risk for the incidence of AF (HR: 0.22; 95% CI 0.06 to 0.83). Compared with the control group, the prevalence of syncope and AF were significantly higher in the WPW group. During follow-up, no difference was identified in outcome measures consisting of all-cause death, cardiac transplantation, and implantable cardioverter-defibrillator intervention. A previous history of AF (HR: 5.20; 95% CI 2.63 to 10.30, p <0.001) and persistent existing WPW (HR: 3.64; 95% CI 1.63 to 8.11, p = 0.002) were independent risk factors for AF occurrence during follow-up in the entire cohort. In conclusion, although WPW was uncommon and might not be correlated with mid-term mortality in HC patients, WPW might increase the risk of AF occurrence. Additionally, AP elimination may reduce the risk of AF occurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accessory Atrioventricular Bundle / surgery
  • Adult
  • Atrial Fibrillation / epidemiology*
  • Cardiomyopathy, Hypertrophic / epidemiology*
  • Case-Control Studies
  • Catheter Ablation
  • China / epidemiology
  • Cohort Studies
  • Defibrillators, Implantable
  • Echocardiography
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Atria / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency / epidemiology
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Syncope / epidemiology
  • Wolff-Parkinson-White Syndrome / epidemiology*
  • Wolff-Parkinson-White Syndrome / therapy