HCM

HCM AFIB ANTICOAGULATION

       -In regards to anticoagulation, Under normal circumstances, we would
    utilize the CHADS2-VASc scoring system for risk of thromboembolic
        events.  However, in those studies, HCM patients were not included (in
        most of those studies) and thus is not be clinically applicable
  -There have been several studies linking the increased risk of
    Afib and CVA with HCM (Olivotto I et al.  "Impact of atrial
    fibrillation on the clinical course of hypertrophic
    cardiomyopathy." Circulation. 2001;104(21):2517.)
            -This is reflected in the 2014 AHA / ACC Afib guidelines in that
    the anticoagulation should be given for HCM patients
    independent of CHADS2-VASc score (Class I indication)

HCM - AFIB AAD 

        -In regards to AAD, the 2014 AHA / ACC AFib guidelines give Amiodarone 

         or Disopyramide (in conjuncture with an AVN Blocking Agent) to prevent 

         recurrent afib in patients with HCM (January, Craig et al.  "2014 AHA / 

         ACC / HRS Guideline for the management of patients with atrial 

         fibrillation." Circulation. 2014;130:e199-e267)