Why the study?
Alcohol septal ablation is increasingly used for medically refractory HOCM, but it may have an increased potential to create a proarrhythmic substrate compared with septal myectomy.
Does alcohol septal ablation increase the risk of ventricular arrhythmias compared to septal myectomy in patients with medical refractory hypertrophic obstructive cardiomyopathy?
Does alcohol septal ablation increase the risk of ventricular arrhythmias compared to septal myectomy in patients with medical refractory hypertrophic obstructive cardiomyopathy?
Alcohol septal ablation is associated with a higher risk of ventricular arrhythmias and sudden cardiac death compared to septal myectomy in patients with hypertrophic obstructive cardiomyopathy.
Answers are grounded in this paper and cite their sources.
May favor myectomy over alcohol ablation to reduce arrhythmic risk in refractory HOCM; leaves open need for randomized confirmation.
Background: Alcohol septal ablation (ASA) has been more commonly applied in medical refractory hypertrophic obstructive cardiomyopathy (HOCM) compared with septal myectomy (SM), however its potential to create a proarrhythmic substrate is increased. Methods: A systematic search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to October 2020. Fixed or random effects models were used to estimate the risk ratios (RR) for ventricular arrhythmia events or other outcomes between the SM and ASA cohorts. Conclusions: In patients with HOCM, those who received ASA showed a higher incidence of VF/VT and SCD combined with resuscitated SCA. The majority of VT/VF occurred in the early phase.
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Tang et al. (2022) studied this question.
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