Long-Term Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

In a case series with up to 9 years of follow-up, cardiac death and aborted sudden cardiac death were significantly more common after ASA than after surgical myectomy.

Alcohol septal ablation (ASA) has emerged as a less-invasive alternative to surgical myectomy in the treatment of patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM). The acute hemodynamic benefits of the two procedures are similar, but little is known about long-term outcomes of ASA. In this single-center study, 91 consecutive patients who underwent ASA were followed for ≤9 years (mean, 5.4 years).

The mean peak pressure gradient decreased from 92 mm Hg to 8 mm Hg immediately after ASA. Procedural mortality was 2%, and subsequent mortality was 7% from sudden cardiac death (SCD) and 1% from heart failure. Twelve percent of patients survived ≥1 ventricular arrhythmias. Implantable cardioverter-defibrillators (ICDs) were i…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI