Season 3 - Ep.25: Arrhythmias in cardiac amyloidosis - Taking the 'O' out of HOCM: managing LVOT obstruction

Oct 23, 2025

Stephanie Schwarting, a cardiac amyloidosis expert from University Hospital Munich, dives into arrhythmias in transthyretin cardiac amyloidosis, discussing management strategies and the nuances of treating atrial fibrillation in this context. Ahmad Masri, a cardiologist specializing in hypertrophic cardiomyopathy from Oregon Health & Science University, explores the complexities of managing LVOT obstruction and the role of myosin inhibitors versus traditional therapies. Both guests provide invaluable insights into cutting-edge treatments and patient management approaches.

Ask episode

AI Snips

Chapters

Transcript

Episode notes

INSIGHT

Why AF Is So Harmful In ATTR Amyloidosis

Atrial fibrillation is very common in ATTR cardiac amyloidosis and often appears in advanced disease stages.
AF is poorly tolerated because loss of atrial contraction and irregular, short RR intervals reduce cardiac output in already impaired diastolic filling.

ADVICE

Stage-Based AF Management Strategy

Tailor AF management to disease stage and prefer rhythm control early in ATTR amyloidosis.
Switch to rate-control strategies in advanced stages where maintaining sinus rhythm is less feasible.

ADVICE

Anticoagulate Regardless Of CHADS-VASc

Anticoagulate patients with ATTR amyloidosis who have atrial fibrillation regardless of CHA2DS2-VASc score.
Perform transesophageal echocardiography before cardioversion or ablation due to high left atrial thrombogenicity.

Get the Snipd Podcast app to discover more snips from this episode

Get the app

This episode covers:

Cardiology This Week: A concise summary of recent studies
Arrhythmias in cardiac amyloidosis
Taking the 'O' out of HOCM: managing LVOT obstruction
Snapshots

Host: Susanna Price

Guests: Carlos Aguiar, Stephanie Schwarting, Ahmad Masri

Want to watch that episode? Go to: https://esc365.escardio.org/event/2176

Want to watch that extended interview on Arrhythmias in Cardiac Amyloidosis? Go to: https://esc365.escardio.org/event/2176?resource=interview

Disclaimer:

ESC TV Today is supported by Bristol Myers Squibb and Novartis through an independent funding. The programme has not been influenced in any way by its funding partners.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

The ESC is not liable for any translated content of this video. The English language always prevails.

Declarations of interests:

Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Ahmad Masri has declared to have potential conflicts of interest to report: research grants from Pfizer, Ionis, Attralus, Cytokinetics and Janssen. Consulting fees from Cytokinetics, BMS, BridgeBio, Pfizer, Ionis, Lexicon, Attralus, Alnylam, Haya, Alexion, Akros, Edgewise, Rocket, Lexeo, Prothena, BioMarin, AstraZeneca, Avidity, Neurimmune, and Tenaya.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Stephanie Schwarting has declared to have potential conflicts of interest to report: advisory board for Alnylam, Bayer, Pfizer; principal investigator in trials sponsored by Alexion, Novo Nordisk and Intellia.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.