Abstract 14417: Implications of Atrial Fibrillation on Clinical Outcomes of Patients With Hypertrophic Obstructive Cardiomyopathy

Abstract

Introduction: Atrial fibrillation is a comorbidity often seen in patients with hypertrophic cardiomyopathy (HCM); however, contemporary data on its prevalence and clinical implications in the obstructive variant of HCM is scarce. Hypothesis: We sought to study the outcomes and implications of atrial fibrillation among patients hospitalized with hypertrophic obstructive cardiomyopathy (HOCM). Methods: Patients with a principal discharge diagnosis of HOCM between 2016 and 2019 were identified in the National Readmissions Database. Among those, patients with and without a diagnosis of atrial fibrillation were categorized. HOCM hospitalizations with atrial fibrillation were matched 1:1 fashion to HOCM without atrial fibrillation. Results: Of the 40,516 HOCM hospitalizations, 14,637 (36.12%) had a secondary diagnosis of atrial fibrillation. Propensity score-matched comparison between HOCM with and without atrial fibrillation (Figure 1) showed higher cardiogenic shock (2.69% vs. 1.98%, p-value <0.01), and acute stroke (3.85% vs 2.91%, p-value <0.01) as compared with HFpEF without atrial fibrillation (Table 1). Total charges were higher in HOCM with atrial fibrillation compared to patients without atrial fibrillation ($ ($86,392.6 vs. $83,762.21). The 30 days all-cause readmission rate among patients admitted with HOCM with AF was higher than those without AF (15.91% vs 14.80, p-value <0.01). Conclusions: In patients with HOCM presence of atrial fibrillation was associated with higher cardiogenic shock and acute stroke.