This study found that AF was not a frequent cause of death by heart failure or sudden cardiac arrest. However, the researchers identified AF as an important cause of stroke in HCM patients. Therefore, they recommend a low threshold for starting HCM patients on anti-coagulants following an initial AF episode.
Researchers in this study analyzed statistics from 1558 HCM patients, 20% of whom experienced AF. 74% experienced only sporadic episodes, while 26% went on to develop permanent AF.
At the time of publication, 91% of the 277 of the patients included in the sample were still alive and between the ages 49 and 75 years old.
Spirito also noted that it is difficult to predict whether a given HCM patient will go on to develop permanent Afib after a single episode since many will not. Additionally, permanent afib can be well tolerated when there is contemporaneous control of heart rate. Therefore, anti-arrhythmic medications, which can cause unpleasant side effects, may not be necessary for HCM patients with afib as long as anti-coagulation measures are taken.
According to new research presented at last week’s meeting of the Heart Rhythm Society, aspirin is not effective in preventing strokes in patients with atrial fibrillation, and in some instances may actually do more harm than good.
In fact, the study, led by Dr. Jared Bunch from Intermountain Healthcare system, Salt Lake City, UT, found that patients who were prescribed aspirin following catheter ablation procedures to treat atrial fibrillation were significantly more likely to suffer gastrointestinal or genitourinary bleeding than those who took other anticoagulants like warfarin, or those who received no treatment at all.
Start-up tech company Cardiogram paired up with electrophysiologists at the University of California, San Francisco to try out the technology on patients awaiting cardioversion for atrial fibrillation. 51 patients at UCSF agreed to wear Apple Watches during their cardioversion procedures.
Heart rate samples were obtained before the procedure, when the patient was in atrial fibrillation, and again afterward when heart rhythm had been restored to normal. The researchers found that the Apple Watches were able to detect afib 97% of the time.
The Cardiogram and UCSF teams hope to publish their findings in a peer-reviewed journal while Cardiogram hopes it can make this information useful to consumers. One possibility would be to have the watch send a notification to the wearer that s/he appears to be in afib should contact her/his care provider immediately.
If you are interested in participating in this research, click here.
The researchers concluded that even though the success rate for HCM patients was approximately half that of patients who suffered from AFib but did not have HCM, catheter ablation is still an effective treatment for HCM patients; especially for those HCM patients who suffer from paroxysmal AFib and who have smaller atria.
Of the patients experiencing AF for the first time, 14 of 16 (88%) of the patients were not aware of having experienced any clinical symptoms. As patients age, AF appears to be a common consequence of HCM. Patients may be caught unaware and unprepared, so monitoring is especially important.