Mariko Harper, 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.

Learn when cardiac myosin inhibitors suffice and when myectomy or alcohol ablation fits, with shared decisions at expert HCM centers.

MAPLE HCM reveals aficamten beats beta blockers in obstructive HCM, reshaping first-line therapy debates amid insurance hurdles.

Explore how aficamten’s shorter half-life enables faster titration, flexible echo monitoring, and fewer drug interactions—making HCM treatment more patient-friendly and accessible.

When beta blockers fall short in obstructive HCM, explore myosin inhibitors, disopyramide, or septal reduction—and see why patients breathe easier.

When beta blockers fall short in obstructive HCM, explore myosin inhibitors, disopyramide, or septal reduction—and learn why patients breathe easier.

Learn key hypertrophic cardiomyopathy symptoms and how echoes with Valsalva or exercise reveal hidden LVOT obstruction for accurate diagnosis.

Panelists discuss the signs, symptoms, diagnostic delays, and classification of obstructive hypertrophic cardiomyopathy, including how it differs from other forms and its implications for clinical management.

Panelists discuss the challenges and gaps in diagnosing hypertrophic cardiomyopathy, including variability in clinical practice, underdiagnosis, and opportunities to improve detection.

Martinez and Harper outline practical workflows for initiating and titrating cardiac myosin inhibitors, emphasizing multidisciplinary team structure, telemedicine, and logistics around REMS and imaging.

Martinez and Harper describe a hub-and-spoke model for HCM care, follow-up cadence, and a structured “4-pillar” framework for longitudinal management, including imaging, biomarkers, and family-based risk strategies.

Martinez and Harper review real-world REMS data on cardiac myosin inhibitors, refine approaches to safety monitoring, and question how frequently echocardiography is truly needed in stable oHCM patients.

Martinez and Harper discuss the limits of current therapies, the role of septal reduction procedures versus cardiac myosin inhibitors, and the complexities of managing younger and childbearing-age patients with oHCM.

Experts explore the concept of “gradient reduction therapy,” the remodeling effects of cardiac myosin inhibitors, and the evolving role of traditional agents in oHCM.

Experts introduce the contemporary treatment paradigm for oHCM, emphasizing earlier diagnosis, cardiac myosin inhibitor use, and objective assessment of “asymptomatic” patients.