Key result
Alcohol septal ablation is linked to a ~76% reduction in outflow gradient and improved dyspnea.
Why the study?
Outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy under multicenter and multinational conditions were not well characterized.
Does alcohol septal ablation improve outflow gradient and dyspnea in patients with hypertrophic obstructive cardiomyopathy?
Cohort (n=459)
Yes
Does alcohol septal ablation improve outflow gradient and dyspnea in patients with hypertrophic obstructive cardiomyopathy?
Alcohol septal ablation for hypertrophic obstructive cardiomyopathy in a real-world European multicenter cohort demonstrates significant improvements in outflow gradient and symptoms with low early mortality (0.7%) and a 9% rate of pacemaker implantation.
Supports short-term safety of alcohol septal ablation in obstructive HCM; leaves open need for randomized confirmation before practice change.
BACKGROUND: This study was designed to evaluate the outcomes of alcohol septal ablation (ASA) under multicenter and multinational conditions. METHODS: Data for 459 patients (age 57 ± 13 years) from nine European centers were prospectively collected and retrospectively analyzed. RESULTS: ASA led to a significant reduction in outflow gradient (PG) and dyspnea [median of PG from 88 (58-123) mm Hg to 21 (11-41) mm Hg; median of NYHA class from 3 (2-3) to 1 (1-2); P < 0.01]. The incidence of 3-month major adverse events (death, electrical cardioversion for tachyarrhythmias, resuscitation) and mortality was 2.8% and 0.7%, respectively. Permanent pacemakers for post-ASA complete heart block were implanted in 43 patients (9%). Multivariate analysis identified higher amount of alcohol (however, in generally low-dose procedures), higher baseline left ventricular ejection fraction and higher age as independent predictors of PG decrease ≥50%. CONCLUSIONS: The results of the first European multicenter and multinational study demonstrate that real-world early outcomes of ASA patients are better than was reported in observations from the first decade after ASA introduction.
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Veselka et al. (2013) conducted a cohort in Hypertrophic obstructive cardiomyopathy (n=459). Alcohol septal ablation was evaluated on Outflow gradient (PG) and dyspnea (p=<0.01). Alcohol septal ablation significantly reduced outflow gradient (median 88 to 21 mm Hg) and dyspnea (median NYHA class 3 to 1) (P<0.01), with a 3-month major adverse event rate of 2.8%.
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