Key result
Alcohol septal ablation is a safe and effective minimally invasive alternative to surgical myectomy that improves symptoms in the majority of patients with drug-refractory hypertrophic obstructive cardiomyopathy.
Why the study?
Does alcohol septal ablation improve symptoms in patients with hypertrophic obstructive cardiomyopathy and drug-refractory symptoms secondary to LVOTO?
Does alcohol septal ablation improve symptoms in patients with hypertrophic obstructive cardiomyopathy and drug-refractory symptoms secondary to LVOTO?
This review provides an overview of alcohol septal ablation as a treatment option for patients with hypertrophic obstructive cardiomyopathy and drug-refractory symptoms.
May support alcohol septal ablation in refractory HOCM; extends observational data but leaves open randomized comparisons to myectomy.
Hypertrophic cardiomyopathy (HCM) is an inherited myocardial disorder characterised by left ventricular hypertrophy. A subgroup of patients develops limiting symptoms in association with left ventricular outflow tract obstruction (LVOTO). Current international guidelines recommend that symptomatic patients are initially treated by alleviating exacerbating factors and negatively inotropic medication. Drug-refractory symptoms require a comprehensive evaluation of the mechanism of LVOTO and review by a multidisciplinary team to consider the relative merits of myectomy, alcohol septal ablation (ASA) and pacing. This article provides a brief overview of HCM and the pathophysiology of LVOTO, and reviews the use of ASA in patients with drug-refractory symptoms secondary to LVOTO.
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O’Mahony et al. (2011) conducted a review in Hypertrophic Obstructive Cardiomyopathy. Alcohol Septal Ablation vs. Surgical myectomy was evaluated. Alcohol septal ablation is a safe and effective minimally invasive alternative to surgical myectomy that improves symptoms in the majority of patients with drug-refractory hypertrophic obstructive cardiomyopathy.
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