Abstract
The current information about features of atrial fibrillation in patients with hypertrophic cardiomyopathy is presented in this review. The data about prevalence, pathogenesis and its various complications in these patients are disclosed. The article contains updated clinical recommendations of authoritative medical societies on the discussing problem. There is detailed discussion of risk factors of atrial fibrillation onset in setting of hypertrophic cardiomyopathy with demonstration of results of different studies concerning to investigation of relationship between risk factors and probability of the arrhythmia development. There is description of detection methods, clinical manifestations, and the course of atrial fibrillation in patients with hypertrophic cardiomyopathy. The contemporary literature data are presented regarding to the management of patients with atrial fibrillation with use of anticoagulants, antiarrhythmic drugs, indications for performing of radiofrequency ablation and results of studies concerning long-term efficacy of such procedure are demonstrated. The discussion on the management of the patients in cases of sinus rhythm restoration or maintenance failure is described.
Highlights
The current information about features of atrial fibrillation in patients with hypertrophic cardiomyopathy is presented in this review
There is detailed discussion of risk factors of atrial fibrillation onset in setting of hypertrophic cardiomyopathy with demonstration of results of different studies concerning to investigation of relationship between risk factors and probability of the arrhythmia development
In patients with HCM who have additional risk factors for atrial fibrillation (AF), such as left atrial dilatation, advanced age, and NYHA class III to class IV heart failure (HF), and who are eligible for anticoagulation, extended ambulatory monitoring is reasonable to screen for AF as part of initial evaluation and periodic follow-up
Summary
The authors declare that this study, its theme, subject and content do not affect competing interests. Гипертрофическая кардиомиопатия (ГКМП) — патологическое состояние, при котором морфологическая экспрессия ограничена только сердцем, и характеризуется преимущественно гипертрофией левого желудочка (ЛЖ) при отсутствии других кардиальных, системных или метаболических заболеваний, способных вызвать выраженную гипертрофию у конкретного больного, у которого идентифицирована мутация саркомера, вызывающего заболевание, или же генетическая этиология остается невыясненной [1,2,3,4,5]. ГКМП — аутосомно-доминантное заболевание, среди причин которого рассматривают мутации генов, кодирующих регуляторные, сократительные и структурные белки кардиальных саркомеров [7,8,9]. К настоящему времени у больных с ГКМП выявлено как минимум 13 генов с более чем 1500 мутациями, экспрессированными преимущественно или исключительно в тканях сердца [5, 9,10,11]. Целью представленного обзора явилось обобщение литературных данных, посвященных эпидемиологии, патогенетическим особенностям, клиническим проявлениям, методам скрининга и лечению ФП при ГКМП
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