James MacNamara, MD

Specialists outline practical counseling, monitoring, and anticoagulation strategies for community cardiologists managing oHCM.

Specialists detail antiarrhythmic use, procedural referral timing, and the atrial remodeling paradox seen with cardiac myosin inhibitors.

Specialists discuss stroke risk, REMS hospitalization data, and how aficamten's early AFib signal compares against mavacamten.

Clinicians examine the association between atrial arrhythmias and transient ejection fraction drops during cardiac myosin inhibitor therapy.

An investigator details MARVEL registry findings on AFib prevalence and ejection fraction outcomes with real-world mavacamten use.

A multicenter registry investigator details real-world AFib incidence with mavacamten and compares it against pivotal trial findings.

Clinicians weigh how their real-world obstructive HCM patients compare with EXPLORER-HCM and VALOR-HCM trial cohorts.

Atrial fibrillation (AFib) is common in patients with hypertrophic cardiomyopathy (HCM) and, once identified, raises immediate questions about how aggressively to pursue rhythm control. In this segment, Mariko Harper, MD, MS, FACC, director of the Hypertrophic Cardiomyopathy Center of Excellence at Virginia Mason Franciscan Health, and James MacNamara, MD, a non-invasive cardiologist and HCM specialist at UVA Health, compare their screening habits and management philosophies before turning to what the pivotal cardiac myosin inhibitor (CMI) trials showed about AFib risk.

Atrial fibrillation (AFib) has long shadowed hypertrophic cardiomyopathy (HCM), but the arrival of cardiac myosin inhibitor (CMI) therapy has sharpened the question of what that relationship really means. As real-world experience with mavacamten and aficamten accumulates alongside pivotal trial data and new adolescent findings from SCOUT-HCM, clinicians are working to reconcile a safety signal that looks different depending on where they look.