Guttmann et al reported predictors of atrial fibrillation in a patient with hypertrophic cardiomyopathy. These can help to identify a patient at greater risk. The authors are from multiple institutions in Europe and are Hypertrophic Cardiomyopathy Outcomes Investigators.
Patient selection: hypertrophic cardiomyopathy
Predictors from multivariate analysis with low p-values:
(1) female sex (HR 1.35)
(2) increasing age (HR 1.23 per decade)
(3) left atrial size in mm (HR 2.39)
An equation approximating the relationship between left atrial diameter and risk is:
5-year risk of atrial fibrillation =
= (0.0003133 * ((diameter)^2)) - (0.01403 * (diameter)) + 0.158
Additional factors associated with risk:
(4) NYHA III or IV (HR 1.65)
(5) hypertension (HR 1.17)
(6) vascular disease (HR 1,41; myocardial infarction, complex aortic plaque; PAD)
Therapy with beta-blockers, calcium channel antagonists and disopyramide initially helped to preserve sinus rhythm but this benefit was lost over time.
