What question did this study set out to answer?

To evaluate the acute and mid-term results of percutaneous transluminal septal myocardial ablation in symptomatic patients with hypertrophic obstructive cardiomyopathy.

December 1, 1998Circulation

Percutaneous Transluminal Septal Myocardial Ablation in Hypertrophic Obstructive Cardiomyopathy

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertrophic Obstructive Cardiomyopathy (n=91). Intervention: Intraprocedural myocardial contrast echocardiography (MCE) during PTSMA vs. Probatory balloon occlusion alone. Primary outcome: Acute success (p=<0.01).

View Full Paper

Ask AI

Bookmark

Key result

Intraprocedural myocardial contrast echocardiography during PTSMA was associated with higher acute (92% vs 70%; P<0.01) and mid-term (94% vs 64%; P<0.01) success compared to balloon occlusion alone.

Why the study?

Does intraprocedural myocardial contrast echocardiography improve the success of percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy?

Population

91 symptomatic patients with hypertrophic obstructive cardiomyopathy, mean age 54.1 years, 46 women and 45…

Comparison

Percutaneous transluminal septal myocardial… vs PTSMA with target vessel determination by…

Design

Cohort

Follow-up

3 months

Authors

LFLothar FaberHeart Failure & Transplant HSHubert SeggewißInterventional Cardiology UGU. GleichmannHeart and Diabetes Center North Rhine-Westphalia

Discussion

Member takes

Implication

PTSMA with MCE may reduce LVOTG in symptomatic HOCM; leaves open need for RCTs versus surgery.

Key Points

To evaluate the acute and mid-term results of percutaneous transluminal septal myocardial ablation in symptomatic patients with hypertrophic obstructive cardiomyopathy.
Ablation performed on 91 symptomatic patients (46 women, 45 men), average age 54.1 years.
Intra-procedural myocardial contrast echocardiography (MCE) was utilized alongside probatory balloon occlusion to determine the target vessel.
Assessments included changes in left ventricular outflow tract gradient and New York Heart Association class pre- and post-intervention.
Resting left ventricular outflow tract gradient reduced from 73.8 mm Hg to 16.6 mm Hg (P<0.0001) and non-extrasystolic gradient from 149.3 mm Hg to 61.9 mm Hg (P<0.0001).
After 3 months, NYHA class improved from 2.8 to 1.1 (P<0.0001) and gradient at rest remained reduced at 14.6 mm Hg.
Target vessel determination by MCE resulted in higher acute success rates (92% vs 70%; P<0.01) and mid-term success rates (94% vs 64%; P<0.01).

Study Design

Type

Cohort (n=91)

Structured PICO

Does intraprocedural myocardial contrast echocardiography improve the success of percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy?

Population

91 symptomatic patients (mean age 54.1 years, 50.5% female) with hypertrophic obstructive cardiomyopathy undergoing percutaneous transluminal septal myocardial ablation, followed for 3 months.

Exposure

Percutaneous transluminal septal myocardial ablation (PTSMA) with target vessel determination by intraprocedural myocardial contrast echocardiography (MCE) (n=61).

Comparator

PTSMA with target vessel determination by probatory balloon occlusion alone (n=30).

Outcome

Reduction in left ventricular outflow tract gradient (LVOTG) and New York Heart Association (NYHA) class at 3 months.surrogate

Main Result

Absolute Event Rate: 92% vs 70%

p-value: p=<0.01

PTSMA effectively reduces LVOTG and symptoms in HOCM, and the addition of intraprocedural myocardial contrast echocardiography significantly improves procedural success rates.

Limitations

Lack of prospective, long-term observations of larger populations
Lack of comparison with established forms of therapy

Cite This Study

Faber et al. (1998) conducted a cohort in Hypertrophic Obstructive Cardiomyopathy (n=91). Intraprocedural myocardial contrast echocardiography (MCE) during PTSMA vs. Probatory balloon occlusion alone was evaluated on Acute success (p=<0.01). Intraprocedural myocardial contrast echocardiography during PTSMA was associated with higher acute (92% vs 70%; P<0.01) and mid-term (94% vs 64%; P<0.01) success compared to balloon occlusion alone.

synapsesocial.com/papers/6a5d7ecffbfab74aebc2822a https://doi.org/10.1161/01.cir.98.22.2415

Topics

Hypertrophic cardiomyopathy Echocardiography AF ablation outcomes

View Full Paper

Ask AI

Bookmark

Percutaneous Transluminal Septal Myocardial Ablation in Hypertrophic Obstructive Cardiomyopathy

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Percutaneous Transluminal Septal Myocardial Ablation in Hypertrophic Obstructive Cardiomyopathy

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider