Incidence of stroke in patients with hypertrophic cardiomyopathy in stable sinus rhythm during long-term monitoring

Abstract Background Patients with hypertrophic cardiomyopathy (HCM) are at increased risk of atrial fibrillation (AF) and stroke, especially an advanced disease stage. To date, however, the incidence factors associated cardioembolic events in HCM patients without AF remain unresolved. Purpose determine stroke whom cardiac rhythm was monitored a implantable electronic device (CIED). The association left (LA) enlargement also examined. Methods Retrospective cohort study outpatient clinic tertiary Referral Center. All consecutive diagnosed referred for CIED implantation >16 years diagnosis >1 year follow-up post were reviewed. Severe LA dilatation defined as dimension (LAD) >48mm echocardiogram. Based on monitoring, classified as: Pre-existing (diagnosed prior to CIED); De novo after implantation); Sinus Rhythm (SR): no episodes AF. Incidence primary outcome. Results A total 185 (57% men, age: 54±17 years) implanted included. present 72 (36%) de 24 (13%); whereas 89 (48%) remained SR. After 5 [2–9] years, reported 19 (10.3%) patients: 7 occurred pre-existing (1.1%/year), 3 (2.2%/year), 9 SR (2.3%/year). No difference captured by CHA2DS2-VASc score among categories. had larger LAD baseline. Among SR, those LAD>48mm greatest (4.8%/year vs 0.5%/year, p<0.01; Hazard Ratio [HR]: 8.56, 95% C.I. 2.03–36.15). At Cox multivariable regression analysis, (HR: 1.104, 95%C.I. 1.039–1.173, p=0.001) 0.310, 0.102–0.939, p=0.038) incident stroke. Conclusions In long-term monitoring history AF, rates similar or stable sinus rhythm. considerably underestimated risk, severe powerful predictor irrespective Funding Acknowledgement Type funding sources: None.