Results of Ten-Year Follow-Up of Alcohol Septal Ablation in Patients with Obstructive Hypertrophic Cardiomyopathy

Abstract

This study looks at 10-year follow-up outcomes of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy.

Between 2000 and 2008, 40 patients with obstructive hypertrophic cardiomyopathy (27 males, 13 females) underwent alcohol septal ablation. The median follow-up period was 123 (2–179) months. The mean age ran to 43.8 + 13.9 years. The initial dose of ethanol (3 mL) was chosen for ablation in all cases.

The hospital mortality was 0%. Permanent pacemakers were implanted in 3 of 40 (7.5%) cases in the hospital period. The median clinical follow-up was 123 (2–179) months. Survival rates at 1, 5, 10, and 15 years after the procedure were as follows: 97.5% (95% confidence interval [CI], 95.1–99.9%), 92.5% (95% CI, 94.8–90.2%), 85.0% (95% CI, 82.9–87.1%), and 81.3% (95% CI, 79.3–83.3%), respectively. Seven patients died during follow-up. Sudden death was observed in two cases. Permanent pacemakers were implanted in 2 of 40 (5%) cases in the follow-up. The log-rank test revealed no statistically significant difference between the 15-year survival rate in our cohort and age- and sex-matched general Russian population (p = 0.11113).

Alcohol septal ablation provides long-term survival rates that look comparable with age- and sex-matched general population in the 15-year follow-up period.

Keywords

coronary intervention - cardiovascular disease - endovascular procedure - percutaneous - intramyocardial - infarction - hemodynamics

• References

• 1 Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet 1995; 346 (8969): 211-214
• 2 Maron BJ, Yacoub M, Dearani JA. Controversies in cardiovascular medicine. Benefits of surgery in obstructive hypertrophic cardiomyopathy: bring septal myectomy back for European patients. Eur Heart J 2011; 32 (09) 1055-1058
• 3 Veselka J, Jensen MK, Liebregts M. , et al. Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy: results from the Euro-ASA registry. Eur Heart J 2016; 37 (19) 1517-1523
• 4 de la Torre Hernandez JM, Masotti Centol M, Lerena Saenz P. , et al. Effectiveness and safety beyond 10 years of percutaneous transluminal septal ablation in hypertrophic obstructive cardiomyopathy. Rev Esp Cardiol (Engl Ed) 2014; 67 (05) 353-358
• 5 Wojtarowicz A, Kornacewicz-Jach Z. Alcohol septal ablation in hypertrophic cardiomyopathy utilizing a longitudinal 17-year study (mean 10.8). Observation follow-ups taken at a single medical centre. Cardiol J 2017; 24 (02) 125-130
• 6 An SY, Yang YJ, Hang F, Wang ZM, Fan CM. Procedural complication and long term outcomes after alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: data from China. Sci Rep 2017; 7 (01) 9506
• 7 Cuisset T, Lefèvre T. Contemporary techniques for catheter-based intervention for hypertrophic obstructive cardiomyopathy. EuroIntervention 2016; 12: X44-X47
• 8 Finkelstein DM, Muzikansky A, Schoenfeld DA. Comparing survival of a sample to that of a standard population. J Natl Cancer Inst 2003; 95 (19) 1434-1439
• 9 Massachusetts General Hospital (MGH). . MGH Biostatistics. Available at: http://biostatistics.mgh.harvard.edu/biostatistics/resources.html . Accessed September 28, 2018
• 10 Liebregts M, Faber L, Jensen MK. , et al. Validation of the HCM Risk-SCD model in patients with hypertrophic cardiomyopathy following alcohol septal ablation. Europace 2018; Sep 1; 20 (FI2): f198-f203
• 11 Nagueh SF, Groves BM, Schwartz L. , et al. Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry. J Am Coll Cardiol 2011; 58 (22) 2322-2328
• 12 Veselka J, Tomašov P, Zemánek D. Long-term effects of varying alcohol dosing in percutaneous septal ablation for obstructive hypertrophic cardiomyopathy: a randomized study with a follow-up up to 11 years. Can J Cardiol 2011; 27 (06) 763-767
• 13 Kuhn H, Lawrenz T, Lieder F. , et al. Survival after transcoronary ablation of septal hypertrophy in hypertrophic obstructive cardiomyopathy (TASH): a 10 year experience. Clin Res Cardiol 2008; 97 (04) 234-243
• 14 Veselka J, Krejčí J, Tomašov P, Zemánek D. Long-term survival after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a comparison with general population. Eur Heart J 2014; 35 (30) 2040-2045
• 15 Sorajja P, Ommen SR, Holmes Jr DR. , et al. Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation 2012; 126 (20) 2374-2380
• 16 Jensen MK, Almaas VM, Jacobsson L. , et al. Long-term outcome of percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: a Scandinavian multicenter study. Circ Cardiovasc Interv 2011; 4 (03) 256-265