A 47-year-old woman with newly diagnosed hypertrophic cardiomyopathy (HCM) presents for initial evaluation. She has read that atrial fibrillation (AF) is common among individuals with HCM and would like to know if there is a way to predict whether she will develop AF.
The correct answer is: A. Family history of AF.
The HCM-AF score is an externally validated predictive tool to identify AF risk in patients with HCM at 2 and 5 years. The variables included in the calculation are:
- LA dimension: +2 points per 6 mm increase
- Age at clinical evaluation: +3 points per 10-year increase
- Age at initial HCM diagnosis: -2 points per 1-year increase
- HF symptoms: +3 points if symptoms are present.
A score of ≤17 is considered to be low risk, 18-21 to be intermediate risk, and ≥22 to be high risk. The risks of developing AF in these categories are <1% per year for low risk, 1-2% per year for intermediate risk, and >2% per year for high risk. Individuals at high risk should participate in shared decision-making regarding increased ambulatory monitoring for AF.
This patient case quiz is part of the larger Hypertrophic Cardiomyopathy: Accelerating Guideline-Driven Care grant. Educational grant support is provided by Bristol Myers Squibb. To visit the Hypertrophic Cardiomyopathy: Accelerating Guideline-Driven Care grant page and access additional educational activities on this topic, click here.
References
- Carrick RT, Maron MS, Adler A, et al. Development and validation of a clinical predictive model for identifying hypertrophic cardiomyopathy patients at risk for atrial fibrillation: the HCM-AF score. Circ Arrhythm Electrophysiol 2021;14:[ePub ahead of print].
Log in to MyACC
