Key result
Alcohol septal ablation is a safe and attractive minimally invasive alternative to surgical myectomy for patients with hypertrophic obstructive cardiomyopathy resistant to medical therapy.
Why the study?
Does alcohol septal ablation reduce left ventricle outflow tract obstruction and symptoms in patients with hypertrophic obstructive cardiomyopathy resistant to conservative medical therapy?
Does alcohol septal ablation reduce left ventricle outflow tract obstruction and symptoms in patients with hypertrophic obstructive cardiomyopathy resistant to conservative medical therapy?
Alcohol septal ablation is a minimally invasive treatment for drug-refractory hypertrophic obstructive cardiomyopathy that effectively reduces outflow gradients and symptoms, though it carries a 10% risk of complete AV block.
Supports less invasive septal reduction for refractory HOCM; extends observational data with randomized confirmation.
Summary Since 1994, alcohol septal ablation (ASA) has been used as a minimally invasive treatment of patients with hypertrophic obstructive cardiomyopathy, resistant to conservative medical therapy. This catheter-based intervention consists of injecting absolute alcohol in a septal perforator to induce infarction of the hypertrophied septum and thus diminish the left ventricle outflow tract obstruction. This reduction of the gradient is associated with reduction of symptoms and left ventricle remodeling. The procedure was improved after the introduction of myocardial contrast echocardiography for visualization of the area at risk of infarction and reduction of the alcohol amount. Major complications of ASA are rare but centers with experience have reported conduction disorders - about 10% of patients needed permanent pacing because of complete AV block. Large randomized prospective studies have not yet compared alcohol septal ablation to the gold standard for treatment of hypertrophic obstructive cardiomyopathy - surgical myomectomy.
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Petrova et al. (2015) conducted a review in Hypertrophic obstructive cardiomyopathy. Alcohol septal ablation vs. Surgical myectomy was evaluated. Alcohol septal ablation is a safe and attractive minimally invasive alternative to surgical myectomy for patients with hypertrophic obstructive cardiomyopathy resistant to medical therapy.
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