{
  "abstract": "Hypertrophic cardiomyopathy is an inherited myocardial disease characterised by overt left ventricular hypertrophy. 1–4 Atrial fibrillation is a common complication.5 6 Due to the unique arrhythmogenic substrate, atrial ablation has limited efficacy,7 8 making predictors of outcome valuable. Left atrial size may predict the onset of atrial fibrillation,9–11 but traditional measurements of size have been variable and inaccurate. This study aims to establish the validity of left atrial volume index (LAVi) by area-length method in predicting outcomes. A retrospective medical notes review was conducted, including 233 patients with hypertrophic cardiomyopathy from the echocardiography database (mean age 53 years, 73% male, median follow-up 8.8 years). The prevalences of atrial arrhythmia and all-cause mortality were 31% and 12% respectively. On multivariate analysis, LAVi predicted incident atrial arrhythmia (HR 1.04 per 1 ml/m2, p<0.0001) and intervention for atrial arrhythmia (composite of atrial ablation and pace-and-ablate, HR 1.02 per 1 ml/m2, p=0.001). LAVi did not predict death. From a case series of 10 patients undergoing atrial ablation, none had freedom from arrhythmia recurrence or reintervention during the follow- up. Overall, atrial arrhythmia is prevalent, and LAVi predicted onset and intervention. Selection for atrial ablation should be extremely judicious, with perhaps a greater role of anti-arrhythmic drugs and pace-and-ablate.References Maron B, Maron M, Olivotto I. Braunwald’s Heart Disease (78: Hypertrophic Cardiomyopathy). Elsevier; 2019.Teare D. Asymmetrical hypertrophy of the heart in young adults. Heart 1958;20(1):1–8.Arbelo E, Protonotarios A, Gimeno JR, Arbustini E, Barriales-Villa R, Basso C, et al. 2023 ESC guidelines for the management of cardiomyopathies. Eur Heart J. 2023;44(37):3503–626.Varnava AM, Elliott PM, Baboonian C, Davison F, Davies MJ, McKenna WJ. Hypertrophic cardiomyopathy. Circulation 2001;104(12):1380–4.Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation 2001;104(21):2517–24.Choi YJ, Choi EK, Han KD, Jung JH, Park J, Lee E, et al. Temporal trends of the prevalence and incidence of atrial fibrillation and stroke among Asian patients with hypertrophic cardiomyopathy: a nationwide population-based study. Int J Cardiol. 2018;273:130–5.Ha HSK, Wang N, Wong S, Phan S, Liao J, Kumar N, et al. Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy patients: a systematic review. Journal of Interventional Cardiac Electrophysiology 2015;44(2):161–70.Providencia R, Elliott P, Patel K, McCready J, Babu G, Srinivasan N, et al. Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis. Heart 2016;102(19):1533–43.Carrick RT, Maron MS, Adler A, Wessler B, Hoss S, Chan RH, et al. 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;14(6).Costabel JP, Galve E, Terricabras M, Ametrano C, Ronderos R, Baranchuk A, et al. E/eʹ ratio and left atrial area are predictors of atrial fibrillation in patients with hypertrophic cardiomyopathy. Echocardiography 2018;35(7):935–40.Bongini C, Ferrantini C, Girolami F, Coppini R, Arretini A, Targetti M, et al. Predictors of atrial fibrillation in hypertrophic cardiomyopathy. Heart 2017;103(9):672–8.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK"
      ],
      "name": "Brandon Tillson"
    },
    {
      "affiliations": [
        "Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK",
        "Freeman Hospital, Newcastle upon Tyne, UK"
      ],
      "name": "Christopher Eggett"
    },
    {
      "affiliations": [
        "Freeman Hospital, Newcastle upon Tyne, UK"
      ],
      "name": "Stephen Lord"
    }
  ],
  "title": "1-042 Left atrial volume index and atrial arrhythmia outcomes in hypertrophic cardiomyopathy",
  "uid": "66133697-0df0-5fe5-a447-acd5833eb1a6"
}