Heart failure & cardiomyopathies

New and recurrent atrial fibrillation in patients with obstructive hypertrophic cardiomyopathy receiving mavacamten

Heart RhythmPublished retrospective observational study

Authors' conclusion

Although patients with oHCM had a high baseline risk of AF, mavacamten treatment was associated with an increased risk of AF development beyond that predicted by the HCM-AF score.

Study context

Population
Patients with obstructive hypertrophic cardiomyopathy (oHCM) undergoing mavacamten treatment at the Johns Hopkins Hypertrophic Cardiomyopathy (HCM) Centerincluding 30 (18.8%) with a diagnosis of atrial fibrillation (AF) before mavacamten treatment
Participants
160 patients
Exposure
Without a previous AF diagnosis vs previous AF diagnosis
  • Previous AF diagnosisn = 30
Outcome
New AF in those without a previous AF diagnosis
Follow-up
Median of 1.4 years of mavacamten treatment (interquartile range 0.6-2.3)

Main finding

As reported in the abstract

Without a previous AF diagnosis

6.4%/y

rate

Observational data: associations, not effects.

Further findings

AF recurrence in patients with a previous AF diagnosis · during mavacamten treatment
19.3%/y · rate

Observed vs HCM-AF predicted risk of symptomatic AF · 2-year

Observed 2-year risk
8.2%
HCM-AF risk prediction
6.9%
  • Observed risk modestly exceeded HCM-AF risk predictions

New, clinically significant AF associated with mavacamten

Hazard ratio (mavacamten, increased risk)
3.0; P = .01
  • Time-dependent multivariable Cox regression

Baseline characteristics and HCM-AF score · mavacamten initiation

Mean age
62 years
Female
58%
Median HCM-AF score
23

HCM-AF score discrimination

Concordance statistic
0.78

Original publication

New and recurrent atrial fibrillation in patients with obstructive hypertrophic cardiomyopathy receiving mavacamten. Heart Rhythm. Published 23 April 2026. doi:10.1016/j.hrthm.2026.04.033

Summarised from the published abstract; every number is checked against it

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