Key result
Mavacamten discontinuation due to reduced LVEF prompts alcohol septal ablation in an HCM case.
Why the study?
To highlight key considerations surrounding septal reduction therapy in the era of mavacamten.
Case Report (n=1)
This case illustrates that septal reduction therapy remains an important option for patients with obstructive hypertrophic cardiomyopathy who cannot tolerate mavacamten due to LVEF reduction.
Reduced LVEF may prompt mavacamten cessation in elderly HCM; leaves open septal ablation as option in drug-intolerant cases.
An 86-year-old-female with hypertrophic cardiomyopathy with persistent obstructive symptoms despite beta blockers and disopyramide was trialed on mavacamten. Although she had improvement in obstructive symptoms, mavacamten was stopped due to reduction in left ventricular ejection fraction even on the lowest dose. Instead, alcohol septal ablation was pursued. This case highlights key considerations surrounding septal reduction therapy in the era of mavacamten.
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Wallace et al. (2025) conducted a case report in Hypertrophic cardiomyopathy with persistent obstructive symptoms (n=1). Mavacamten followed by alcohol septal ablation was evaluated. Mavacamten was stopped in an 86-year-old female with hypertrophic cardiomyopathy due to reduced left ventricular ejection fraction, necessitating alcohol septal ablation.
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