Apical Aneurysms in HCM

A recent paper published by doctors at Canada’s Peter Munk Cardiac Center looked at the implications of left ventricular apical aneurysms in hypertrophic cardiomyopathy,  This paper recommends that patients with an apical aneurysm of at least 2 centimeters consider prophylactic anticoagulant therapy to prevent stroke, as well as considering surgical placement of an implantable defibrillator to protect against sudden cardiac death.

A companion editorial suggests caution in basing aggressive measures on an aneurysm alone and says that all risk factors be considered together.

In 2017, HCMBeat covered a retrospective study of patients treated at Minneapolis Heart Institute and Tufts which discussed the risks for patients with apical aneurysms.  That can be found here.

Arrhythmia Monitoring in HCM

Arrhythmia monitoring in HCM patients is used not only for determining risk of sudden death and potential need for an implantable defibrillator, but also for detecting atrial fibrillation (AFib) and implementing anti-coagulation for stroke prevention.

A recent paper provides an overview of the usefulness of arrhythmia monitoring in patients with HCM. 

Continue reading “Arrhythmia Monitoring in HCM”

Can This Formula Predict AFib in HCM Patients?

HCM specialists at Tufts Medical Center and Toronto General Hospital have devised a formula which they hope will help predict which HCM patients may go on to develop atrial fibrillation (“AFib”) over time. This tool can assist doctors in determining which patients are at highest risk so that these patients can be closely monitored and treated appropriately. AFib can be extremely dangerous for HCM patients since it can precipitate a stroke if not appropriately treated.   

Because existing tools to predict atrial fibrillation have not proven to be accurate for HCM patients, the researchers studied 1900 HCM patients with the goal of devising a new tool to help HCM patients and their physicians learn their personal risk for AFib over a 2 and 5 year period.

Continue reading “Can This Formula Predict AFib in HCM Patients?”

Aspirin May Cause More Harm than Good in Afib

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.

Note that previous studies have demonstrated that aspirin is not effective in preventing strokes from Afib.

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.

For more, see these articles from  Medical News Today  and Science Times (with link to video).

 

Apical Aneurysm is Risk Factor for HCM Patients

A recent retrospective study of patients at Minneapolis Heart Institute and Tufts Medical Center published in the Journal of the American College of Cardiology found that HCM patients who also had left ventricular apical aneurysms were at increased risk of sudden cardiac death and stroke.  However, with increased surveillance and appropriate treatment, including the implantation of a implantable defibrillator, radiofrequency ablation and/or anti-coagulation, as appropriate, the authors suggest that the increased risk can be neutralized.

A summary of this article can be found here.

Better Screening and Treatment Necessary for Atrial Fibrillation

 

An August 20, 2016 article in The Lancet points out that many physicians do not effectively screen for or properly treat Atrial Fibrillation. Furthermore, aspirin, which is often given as a treatment for A-fib, is insufficient to prevent stroke.

If A-Fib is detected, treatment with anti-coagulants is essential.

Aspirin Not Best to Treat A-fib

 

According to a recent study published June 20 in the Journal of the American College of Cardiology, more than 1/3 of patients in atrial fibrillation are not receiving sufficient anti-coagulation.   Many of these patients are receiving only aspirin instead of a more effective blood thinner like warfarin, or one of the newer anti-coagulant drugs like Pradaxa or  Xarelto.