What is the commonest sustained arrhythmia in HCM?

What is the commonest sustained arrhythmia in HCM?

Commonest sustained arrhythmia in hypertrophic cardiomyopathy is atrial fibrillation. Atrial fibrillation (AF) can occur in about 1/5^th of cases of hypertrophic cardiomyopathy (HCM). Factors predisposing to AF in HCM are left atrial pressure and size due to left ventricular diastolic dysfunction, left ventricular outflow tract obstruction and mitral regurgitation. About one fourth of them may develop embolic episodes and stroke. It has been suggested that those with left atrial diameter of 45 mm or more should undergo 48 hour Holter once or twice a year to look for AF. Anticoagulation is recommended in those with AF for prevention of stroke. Patients with HCM may go into heart failure at the onset of AF as atrial booster function is very important contributor of ventricular filling in these patients with left ventricular diastolic dysfunction.

Reference

1. Guttmann OP, Rahman MS, O’Mahony C, Anastasakis A, Elliott PM. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart. 2014 Mar;100(6):465-72.