Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten

<b>Background:</b> Hypertrophic cardiomyopathy (HCM) is a genetic cardiomyopathy marked by increased left ventricular wall thickness, leading in some cases to left ventricular outflow tract (LVOT) obstruction, heart failure, and arrhythmias. Mavacamten, a selective allosteric inhibitor o...

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Main Authors: Amro Badr, Kaitlin Roehl, Mustafa Suppah, Humam Abo Abdullah, Reza Arsanjani, Konstantinos C. Siontis, Jeffrey B. Geske, Steve R. Ommen, John R. Giudicessi, Said Alsidawi
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Language:English
Published: MDPI AG 2025-04-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/4/1005
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author Amro Badr
Kaitlin Roehl
Mustafa Suppah
Humam Abo Abdullah
Reza Arsanjani
Konstantinos C. Siontis
Jeffrey B. Geske
Steve R. Ommen
John R. Giudicessi
Said Alsidawi
author_facet Amro Badr
Kaitlin Roehl
Mustafa Suppah
Humam Abo Abdullah
Reza Arsanjani
Konstantinos C. Siontis
Jeffrey B. Geske
Steve R. Ommen
John R. Giudicessi
Said Alsidawi
author_sort Amro Badr
collection DOAJ
description <b>Background:</b> Hypertrophic cardiomyopathy (HCM) is a genetic cardiomyopathy marked by increased left ventricular wall thickness, leading in some cases to left ventricular outflow tract (LVOT) obstruction, heart failure, and arrhythmias. Mavacamten, a selective allosteric inhibitor of cardiac myosin, has demonstrated benefits in improving hemodynamics and reducing LVOT obstruction. However, its impact on arrhythmic burden remains unclear, with reports of early atrial fibrillation (AF) risk contrasting with long-term reductions in arrhythmias. This study assesses the temporal patterns of Holter-detected arrhythmias in HCM patients treated with mavacamten. <b>Methods:</b> This retrospective study included HCM patients from three Mayo Clinic sites. Baseline demographic, clinical, and echocardiographic data were collected. Holter monitoring was performed at baseline, short-term (<6 months), and long-term (>6 months) follow-up. Arrhythmic events, including premature atrial contractions (PACs), premature ventricular contractions (PVCs), and supraventricular tachycardia (SVT), were analyzed using standardized rates per 24 h. Statistical comparisons utilized the Wilcoxon signed-rank test. <b>Results:</b> Twenty-seven patients (56% female, median age 66 years) were included. PACs, PVCs, and SVT duration transiently but not significantly increased at short-term follow-up but returned to baseline at long-term follow-up. No sustained or high-risk ventricular arrhythmias were observed. <b>Conclusions:</b> Mavacamten is associated with transient arrhythmic fluctuations early in treatment, followed by stabilization. These findings support its long-term electrophysiological safety and underscore the need for early rhythm monitoring. Further research should explore its role in arrhythmic risk stratification in HCM patients.
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spelling doaj-art-56ea290a30664dd2aea6f610b4de098f2025-08-20T02:24:43ZengMDPI AGBiomedicines2227-90592025-04-01134100510.3390/biomedicines13041005Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with MavacamtenAmro Badr0Kaitlin Roehl1Mustafa Suppah2Humam Abo Abdullah3Reza Arsanjani4Konstantinos C. Siontis5Jeffrey B. Geske6Steve R. Ommen7John R. Giudicessi8Said Alsidawi9Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USADepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USADepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA<b>Background:</b> Hypertrophic cardiomyopathy (HCM) is a genetic cardiomyopathy marked by increased left ventricular wall thickness, leading in some cases to left ventricular outflow tract (LVOT) obstruction, heart failure, and arrhythmias. Mavacamten, a selective allosteric inhibitor of cardiac myosin, has demonstrated benefits in improving hemodynamics and reducing LVOT obstruction. However, its impact on arrhythmic burden remains unclear, with reports of early atrial fibrillation (AF) risk contrasting with long-term reductions in arrhythmias. This study assesses the temporal patterns of Holter-detected arrhythmias in HCM patients treated with mavacamten. <b>Methods:</b> This retrospective study included HCM patients from three Mayo Clinic sites. Baseline demographic, clinical, and echocardiographic data were collected. Holter monitoring was performed at baseline, short-term (<6 months), and long-term (>6 months) follow-up. Arrhythmic events, including premature atrial contractions (PACs), premature ventricular contractions (PVCs), and supraventricular tachycardia (SVT), were analyzed using standardized rates per 24 h. Statistical comparisons utilized the Wilcoxon signed-rank test. <b>Results:</b> Twenty-seven patients (56% female, median age 66 years) were included. PACs, PVCs, and SVT duration transiently but not significantly increased at short-term follow-up but returned to baseline at long-term follow-up. No sustained or high-risk ventricular arrhythmias were observed. <b>Conclusions:</b> Mavacamten is associated with transient arrhythmic fluctuations early in treatment, followed by stabilization. These findings support its long-term electrophysiological safety and underscore the need for early rhythm monitoring. Further research should explore its role in arrhythmic risk stratification in HCM patients.https://www.mdpi.com/2227-9059/13/4/1005mavacamtenHCMcardiomyopathyarrythmiaHolter
spellingShingle Amro Badr
Kaitlin Roehl
Mustafa Suppah
Humam Abo Abdullah
Reza Arsanjani
Konstantinos C. Siontis
Jeffrey B. Geske
Steve R. Ommen
John R. Giudicessi
Said Alsidawi
Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten
Biomedicines
mavacamten
HCM
cardiomyopathy
arrythmia
Holter
title Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten
title_full Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten
title_fullStr Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten
title_full_unstemmed Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten
title_short Temporal Patterns of Holter-Detected Arrhythmias in Hypertrophic Cardiomyopathy Patients Treated with Mavacamten
title_sort temporal patterns of holter detected arrhythmias in hypertrophic cardiomyopathy patients treated with mavacamten
topic mavacamten
HCM
cardiomyopathy
arrythmia
Holter
url https://www.mdpi.com/2227-9059/13/4/1005
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