Atrial fibrillation in left ventricular noncompaction with and without neuromuscular disorders is associated with a poor prognosis

Aims: The study in patients with left ventricular hypertrabeculation/ noncompaction (LVHT) aimed to compare patients with and without atrial fibrillation (AF) regarding prevalence of neuromuscular disorders (NMD), cardiac symptoms, electrocardiographic (ECG) findings, left ventricular function, location and extension of LVHT and mortality. Methods and results: LVHT was diagnosed in 102 patients (30 female, age 53 +/- 16 years) between June 1995 and November 2006. A specific NMD was diagnosed in 21, a NMD of unknown etiology in 47, the neurologic investigation was normal in 14, and 20 patients refused. The 15 patients with AF were older (65 versus 51 years, p<0.01), suffered more often from exertional dyspnoea (100 versus 62%, p<0.01), diabetes mellitus (33 versus 12%, p<0.05) and heart failure (100 versus 57%, p<0.01) than patients without AF. The prevalence of NMD was slightly higher in patients with than without AF (87 versus 82%, p=NS). AF patients had more frequent ECG abnormalities (2.3 versus 1.4, pb0.01), valvular abnormalities (93 versus 48%, p<0.01), lateral wall LVHT (87 versus 37%, p<0.01), more extensive LVHT (2.1 versus 1.5 ventricular parts, pb0.05), a worse left ventricular fractional shortening (14 versus 25%, pb0.01) and higher mortality during 3.8 years. Conclusion: LVHT-patients with AF deserve special care because they have a worse prognosis than LVHT-patients without AF. (C) 2007 Elsevier Ireland Ltd. All rights reserved.