Cardiac Myosin Inhibitors and Incident Atrial Fibrillation in Hypertrophic Cardiomyopathy: Systematic Review and Meta-Analysis - PubMed
3 hours ago
- #hypertrophic cardiomyopathy
- #cardiac myosin inhibitors
- #atrial fibrillation
- Cardiac myosin inhibitors (CMIs) improve hemodynamics and symptoms in hypertrophic cardiomyopathy (HCM).
- Recent real-world data raised concerns about increased atrial fibrillation (AF) risk with CMIs.
- A systematic review and meta-analysis of 8 RCTs (n=1581) found no increased AF risk with CMIs (RR 1.11, 95% CI 0.62-1.98).
- No differences in AF risk were observed between mavacamten and aficamten, or across HCM subtypes.
- Most trials excluded patients with uncontrolled, persistent, or permanent AF, limiting representation of high-risk AF phenotypes.
- RCT populations had lower baseline atrial remodeling and restrictive AF eligibility criteria compared to real-world cohorts.
- The findings highlight the need for longitudinal AF monitoring in clinical practice despite RCT results.