Outcome of alcohol septal ablation for obstructive hypertrophic cardiomyopathy.

Abstract:

BACKGROUND:The clinical efficacy of alcohol septal ablation for drug-refractory hypertrophic cardiomyopathy remains unclear. This study examines the outcome of alcohol septal ablation performed at a tertiary hypertrophic cardiomyopathy referral center. METHODS AND RESULTS:Among 601 patients with severely symptomatic obstructive hypertrophic cardiomyopathy referred for alcohol septal ablation or myectomy from 1998 to 2006, 138 patients (median age, 64 years; 39% men) chose to undergo ablation. Procedural complications included death in 1.4%, sustained ventricular arrhythmias in 3%, tamponade in 3%, and pacemaker implantation in 20%. This rate was higher than a combined complication rate of 5% in age- and gender-matched patients who had undergone septal myectomy at Mayo Clinic (P<0.0001). Four-year survival free of all mortality was 88.0% (95% confidence interval, 79.4 to 97.5%), which was similar to that of the age- and gender-matched patients who had undergone myectomy (P=0.18). Six patients had documented ventricular arrhythmias after ablation, 4 of whom had successful intervention. Four-year survival free of death and severe New York Heart Association class III/IV symptoms after septal ablation was 76.4%, and 71 patients (51%) became asymptomatic. Myectomy patients

journal_name

Circulation

journal_title

Circulation

authors

Sorajja P,Valeti U,Nishimura RA,Ommen SR,Rihal CS,Gersh BJ,Hodge DO,Schaff HV,Holmes DR Jr

doi

10.1161/CIRCULATIONAHA.107.738740

subject

Has Abstract

pub_date

2008-07-08 00:00:00

pages

131-9

issue

2

eissn

0009-7322

issn

1524-4539

pii

CIRCULATIONAHA.107.738740

journal_volume

118

pub_type

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