Atrial fibrillation hypertrophic cardiomyopathy: Difference between revisions

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(/* 2011 ACCF/AHA/HRS Guidelines for the Management of Atrial Fibrillation- Hypertrophic Cardiomyopathy (DO NOT EDIT) Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management o...)
(/* 2011 ACCF/AHA/HRS Guidelines for the Management of Atrial Fibrillation- Hypertrophic Cardiomyopathy (DO NOT EDIT) Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management o...)
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In patients with [[hypertrophic cardiomyopathy]] ([[HOCM]]), the factors that contribute to '''systemic embolism''' <ref name="pmid6946758">Hurley DM, Hunter AN, Hewett MJ, Stockigt JR (1981) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=6946758 Atrial fibrillation and arterial embolism in hyperthyroidism.] ''Aust N Z J Med'' 11 (4):391-3. PMID: [http://pubmed.gov/6946758 6946758]</ref><ref name="pmid492021">Yuen RW, Gutteridge DH, Thompson PL, Robinson JS (1979) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=492021 Embolism in thyrotoxic atrial fibrillation.] ''Med J Aust'' 1 (13):630-1. PMID: [http://pubmed.gov/492021 492021]</ref><ref name="pmid902055">Staffurth JS, Gibberd MC, Fui SN (1977) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=902055 Arterial embolism in thyrotoxicosis with atrial fibrillation.] ''Br Med J'' 2 (6088):688-90. PMID: [http://pubmed.gov/902055 902055]</ref><ref name="pmid7259379">Bar-Sela S, Ehrenfeld M, Eliakim M (1981) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7259379 Arterial embolism in thyrotoxicosis with atrial fibrillation.] ''Arch Intern Med'' 141 (9):1191-2. PMID: [http://pubmed.gov/7259379 7259379]</ref> include [[ atrial fibrillation]], advanced age,<ref name="pmid7259379">Bar-Sela S, Ehrenfeld M, Eliakim M (1981) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7259379 Arterial embolism in thyrotoxicosis with atrial fibrillation.] ''Arch Intern Med'' 141 (9):1191-2. PMID: [http://pubmed.gov/7259379 7259379]</ref> [[hypertension]], [[mitral annular calcification]], and [[left atrial enlargment]].<ref name="pmid492021">Yuen RW, Gutteridge DH, Thompson PL, Robinson JS (1979) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=492021 Embolism in thyrotoxic atrial fibrillation.] ''Med J Aust'' 1 (13):630-1. PMID: [http://pubmed.gov/492021 492021]</ref> [[AF]] has been shown to be associated with an increased risk for [[HOCM|HCM-related death]] ''(odds ratio 3.7; P<0.002)'' secondary to excess [[heart failure]]-related mortality but not [[sudden cardiac death]]. [[AF]] patients were also at an increased risk for [[stroke]] ''(odds ratio 17.7; P=0.0001)'' and severe functional limitation ''(odds ratio for [[New york heart association functional classification|NYHA class III or IV]], 2.8; P<0.0001)''.<ref name="pmid11714644">Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ (2001) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11714644 Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy.] ''Circulation'' 104 (21):2517-24. PMID: [http://pubmed.gov/11714644 11714644]</ref> Antiarrhythmic agents such as [[disopyramide]], [[propafenone]], and [[amiodarone]] may be used to prevent [[AF]] episodes and modulate the rate of ventricular response in patients with [[HOCM]].<ref name="pmid9843465">Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9843465 Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators.] ''Circulation'' 98 (23):2574-9. PMID: [http://pubmed.gov/9843465 9843465]</ref>  The medical management of the patient with hypertrophic cardiomyopathy involves minimizing diastolic dysfunction, reducing left ventricular outflow tract obstruction, optimizing [[heart failure]] management, maintaining [[normal sinus rhythm]], rate control and anticoagulation in the presence of [[atrial fibrillation]], and implantation of an [[automatic implantable cardiac defibrillator]] in those patients who survive [[sudden cardiac death]].
In patients with [[hypertrophic cardiomyopathy]] ([[HOCM]]), the factors that contribute to '''systemic embolism''' <ref name="pmid6946758">Hurley DM, Hunter AN, Hewett MJ, Stockigt JR (1981) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=6946758 Atrial fibrillation and arterial embolism in hyperthyroidism.] ''Aust N Z J Med'' 11 (4):391-3. PMID: [http://pubmed.gov/6946758 6946758]</ref><ref name="pmid492021">Yuen RW, Gutteridge DH, Thompson PL, Robinson JS (1979) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=492021 Embolism in thyrotoxic atrial fibrillation.] ''Med J Aust'' 1 (13):630-1. PMID: [http://pubmed.gov/492021 492021]</ref><ref name="pmid902055">Staffurth JS, Gibberd MC, Fui SN (1977) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=902055 Arterial embolism in thyrotoxicosis with atrial fibrillation.] ''Br Med J'' 2 (6088):688-90. PMID: [http://pubmed.gov/902055 902055]</ref><ref name="pmid7259379">Bar-Sela S, Ehrenfeld M, Eliakim M (1981) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7259379 Arterial embolism in thyrotoxicosis with atrial fibrillation.] ''Arch Intern Med'' 141 (9):1191-2. PMID: [http://pubmed.gov/7259379 7259379]</ref> include [[ atrial fibrillation]], advanced age,<ref name="pmid7259379">Bar-Sela S, Ehrenfeld M, Eliakim M (1981) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7259379 Arterial embolism in thyrotoxicosis with atrial fibrillation.] ''Arch Intern Med'' 141 (9):1191-2. PMID: [http://pubmed.gov/7259379 7259379]</ref> [[hypertension]], [[mitral annular calcification]], and [[left atrial enlargment]].<ref name="pmid492021">Yuen RW, Gutteridge DH, Thompson PL, Robinson JS (1979) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=492021 Embolism in thyrotoxic atrial fibrillation.] ''Med J Aust'' 1 (13):630-1. PMID: [http://pubmed.gov/492021 492021]</ref> [[AF]] has been shown to be associated with an increased risk for [[HOCM|HCM-related death]] ''(odds ratio 3.7; P<0.002)'' secondary to excess [[heart failure]]-related mortality but not [[sudden cardiac death]]. [[AF]] patients were also at an increased risk for [[stroke]] ''(odds ratio 17.7; P=0.0001)'' and severe functional limitation ''(odds ratio for [[New york heart association functional classification|NYHA class III or IV]], 2.8; P<0.0001)''.<ref name="pmid11714644">Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ (2001) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11714644 Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy.] ''Circulation'' 104 (21):2517-24. PMID: [http://pubmed.gov/11714644 11714644]</ref> Antiarrhythmic agents such as [[disopyramide]], [[propafenone]], and [[amiodarone]] may be used to prevent [[AF]] episodes and modulate the rate of ventricular response in patients with [[HOCM]].<ref name="pmid9843465">Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN (1998) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9843465 Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators.] ''Circulation'' 98 (23):2574-9. PMID: [http://pubmed.gov/9843465 9843465]</ref>  The medical management of the patient with hypertrophic cardiomyopathy involves minimizing diastolic dysfunction, reducing left ventricular outflow tract obstruction, optimizing [[heart failure]] management, maintaining [[normal sinus rhythm]], rate control and anticoagulation in the presence of [[atrial fibrillation]], and implantation of an [[automatic implantable cardiac defibrillator]] in those patients who survive [[sudden cardiac death]].


==2011 ACCF/AHA/HRS Guidelines for the Management of Atrial Fibrillation- Hypertrophic Cardiomyopathy (DO NOT EDIT) <ref name="pmid16908781">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16908781 ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society.] ''Circulation'' 114 (7):e257-354. [http://dx.doi.org/10.1161/CIRCULATIONAHA.106.177292 DOI:10.1161/CIRCULATIONAHA.106.177292] PMID: [http://pubmed.gov/16908781 16908781]</ref><ref name="pmid21382897">Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2011) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21382897 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.] ''Circulation'' 123 (10):e269-367. [http://dx.doi.org/10.1161/CIR.0b013e318214876d DOI:10.1161/CIR.0b013e318214876d] PMID: [http://pubmed.gov/21382897 21382897]</ref>==
==2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial                     Fibrillation (DO NOT EDIT)<ref name="pmid21392637">{{cite journal| author=Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al.| title=2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2011 | volume= 57 | issue= 11 | pages= e101-98 | pmid=21392637 | doi=10.1016/j.jacc.2010.09.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21392637  }} </ref>==
===Hypertrophic Cardiomyopathy (DO NOT EDIT) <ref name="pmid21392637">{{cite journal| author=Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al.| title=2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2011 | volume= 57 | issue= 11 | pages= e101-98 | pmid=21392637 | doi=10.1016/j.jacc.2010.09.013 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21392637  }} </ref>===
 


{|class="wikitable"
{|class="wikitable"
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Oral [[anticoagulation]] (INR 2.0 to 3.0) is recommended in patients with [[hypertrophic cardiomyopathy]] who develop [[AF]], as for other patients at high risk of [[thromboembolism]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])<nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Oral [[anticoagulation]] (INR 2.0 to 3.0) is recommended in patients with [[hypertrophic cardiomyopathy]] who develop [[AF]], as for other patients at high risk of [[thromboembolism]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
|}


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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Antiarrhythmic medications]] can be useful to prevent recurrent [[AF]] in patients with [[hypertrophic cardiomyopathy]]. Available data are insufficient to recommend one agent over another in this situation, but (a) [[disopyramide]] combined with a [[beta blocker]] or non [[dihydropyridine]] [[calcium channel antagonist]] or (b) [[amiodarone]] alone is generally preferred. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Antiarrhythmic medications]] can be useful to prevent recurrent [[AF]] in patients with [[hypertrophic cardiomyopathy]]. Available data are insufficient to recommend one agent over another in this situation, but (a) [[disopyramide]] combined with a [[beta blocker]] or non [[dihydropyridine]] [[calcium channel antagonist]] or (b) [[amiodarone]] alone is generally preferred. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
|}


Revision as of 13:49, 5 November 2012

Conduction
Sinus rhythm
Atrial fibrillation
'
ICD-10 I48
ICD-9 427.31
DiseasesDB 1065
MedlinePlus 000184

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.

Synonyms and related keywords: AF, Afib, fib

Overview

In patients with hypertrophic cardiomyopathy (HOCM), the factors that contribute to systemic embolism [1][2][3][4] include atrial fibrillation, advanced age,[4] hypertension, mitral annular calcification, and left atrial enlargment.[2] AF has been shown to be associated with an increased risk for HCM-related death (odds ratio 3.7; P<0.002) secondary to excess heart failure-related mortality but not sudden cardiac death. AF patients were also at an increased risk for stroke (odds ratio 17.7; P=0.0001) and severe functional limitation (odds ratio for NYHA class III or IV, 2.8; P<0.0001).[5] Antiarrhythmic agents such as disopyramide, propafenone, and amiodarone may be used to prevent AF episodes and modulate the rate of ventricular response in patients with HOCM.[6] The medical management of the patient with hypertrophic cardiomyopathy involves minimizing diastolic dysfunction, reducing left ventricular outflow tract obstruction, optimizing heart failure management, maintaining normal sinus rhythm, rate control and anticoagulation in the presence of atrial fibrillation, and implantation of an automatic implantable cardiac defibrillator in those patients who survive sudden cardiac death.

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)[7]

Hypertrophic Cardiomyopathy (DO NOT EDIT) [7]

Class I
"1. Oral anticoagulation (INR 2.0 to 3.0) is recommended in patients with hypertrophic cardiomyopathy who develop AF, as for other patients at high risk of thromboembolism. (Level of Evidence: B)"
Class IIa
"1. Antiarrhythmic medications can be useful to prevent recurrent AF in patients with hypertrophic cardiomyopathy. Available data are insufficient to recommend one agent over another in this situation, but (a) disopyramide combined with a beta blocker or non dihydropyridine calcium channel antagonist or (b) amiodarone alone is generally preferred. (Level of Evidence: C)"

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References

  1. ↑ Hurley DM, Hunter AN, Hewett MJ, Stockigt JR (1981) Atrial fibrillation and arterial embolism in hyperthyroidism. Aust N Z J Med 11 (4):391-3. PMID: 6946758
  2. ↑ 2.0 2.1 Yuen RW, Gutteridge DH, Thompson PL, Robinson JS (1979) Embolism in thyrotoxic atrial fibrillation. Med J Aust 1 (13):630-1. PMID: 492021
  3. ↑ Staffurth JS, Gibberd MC, Fui SN (1977) Arterial embolism in thyrotoxicosis with atrial fibrillation. Br Med J 2 (6088):688-90. PMID: 902055
  4. ↑ 4.0 4.1 Bar-Sela S, Ehrenfeld M, Eliakim M (1981) Arterial embolism in thyrotoxicosis with atrial fibrillation. Arch Intern Med 141 (9):1191-2. PMID: 7259379
  5. ↑ Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ (2001) Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation 104 (21):2517-24. PMID: 11714644
  6. ↑ Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN (1998) Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators. Circulation 98 (23):2574-9. PMID: 9843465
  7. ↑ 7.0 7.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA; et al. (2011). "2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". J Am Coll Cardiol. 57 (11): e101–98. doi:10.1016/j.jacc.2010.09.013. PMID 21392637.
  8. ↑ Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114 (7):e257-354. DOI:10.1161/CIRCULATIONAHA.106.177292 PMID: 16908781
  9. ↑ Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 123 (10):e269-367. DOI:10.1161/CIR.0b013e318214876d PMID: 21382897
  10. ↑ Estes NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS et al. (2008) ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society. Circulation 117 (8):1101-20. DOI:10.1161/CIRCULATIONAHA.107.187192 PMID: 18283199

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