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September 23, 2004Catheterization and Cardiovascular Interventions

Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: Lower alcohol dose reduces size of infarction and has comparable hemodynamic and clinical outcome

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Why the study?

Does a lower dose of alcohol reduce infarct size while maintaining comparable clinical and hemodynamic outcomes compared to standard doses in patients undergoing septal ablation for HOCM?

Population

34 patients with highly symptomatic hypertrophic obstructive cardiomyopathy receiving maximum medical therapy

Comparison

Low dose alcohol injected into target septal… vs Standard dose alcohol injected into target…

Design

RCT, 1:1 ratio

Follow-up

6 months

Key result

Low-dose alcohol (1-2 ml) for septal ablation in HOCM resulted in a lower peak CK-MB (1.9 vs 3.2 microkat/L, P<0.05) compared to standard doses, with similar clinical outcomes at 6 months.

Authors

JVJosef VeselkaŠPŠárka ProcházkováRDRadka Duchoňová

Discussion

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Member takes

Overview

Supports lower-dose alcohol septal ablation in HOCM to limit infarct size; extends dosing data with RCT confirmation of similar outcomes.

Study Design

Type

RCT (n=34)

Randomization

1:1

Structured PICO

Does a lower dose of alcohol reduce infarct size while maintaining comparable clinical and hemodynamic outcomes compared to standard doses in patients undergoing septal ablation for HOCM?

P
Population
34 patients with symptomatic hypertrophic obstructive cardiomyopathy receiving maximum medical therapy, followed for 6 months.
I
Intervention
Low dose (1-2 ml, mean 1.6 +/- 0.4 ml) alcohol injected into target septal artery during echocardiography-guided percutaneous transluminal septal myocardial ablation (PTSMA)
C
Comparator
Standard dose (2-4 ml, mean 3.4 +/- 0.9 ml) alcohol injected into target septal artery during PTSMA
O
Outcome
Infarct size (measured by peak CK-MB) and clinical, electrocardiographic, and echocardiographic evaluation at 6 monthssurrogate

Main Result

Absolute Event Rate: 1.9% vs 3.2%

p-value: p=< 0.05

A lower dose of alcohol (1-2 ml) for septal ablation in HOCM reduces infarct size while providing comparable clinical and hemodynamic benefits to standard doses.

Cite This Study

Veselka et al. (2004) conducted an RCT in symptomatic hypertrophic obstructive cardiomyopathy (HOCM) (n=34). Alcohol septal ablation vs. Standard dose (2-4 ml; mean 3.4 +/- 0.9 ml) was evaluated on Peak of CK-MB (p=< 0.05). Low-dose alcohol (1-2 ml) for septal ablation in HOCM resulted in a lower peak CK-MB (1.9 vs 3.2 microkat/L, P<0.05) compared to standard doses, with similar clinical outcomes at 6 months.

synapsesocial.com/papers/6a9c8c83f406cf7e15acb1d7https://doi.org/10.1002/ccd.20176
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