Key result
Recurrent AF post-alcohol septal ablation for HOCM ultimately requires surgical LAA occlusion.
Why the study?
The impact of alcohol septal ablation on the long-term incidence and management of atrial fibrillation in hypertrophic obstructive cardiomyopathy patients remains unclear.
Case Report (n=1)
No
This case highlights that successful relief of left ventricular outflow tract obstruction by alcohol septal ablation in HOCM does not eliminate the long-term risk of atrial fibrillation, emphasizing the need for lifelong surveillance and multidisciplinary management.
Late AF recurrence after alcohol septal ablation may require tailored anticoagulation strategies; leaves open optimal long-term surveillance protocols in hypertrophic obstructive cardiomyopathy.
Alcohol septal ablation (ASA) is an established septal reduction therapy for patients with drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). However, its impact on the long-term incidence of atrial fibrillation (AF) remains unclear. We report a case of a 68-year-old man with HOCM who underwent successful ASA with an improvement in heart failure (HF) symptoms. Four years later, recurrent AF developed, requiring catheter ablation twice. Subsequently, subarachnoid hemorrhage occurred during anticoagulation therapy. Because of the high thromboembolic and bleeding risks and unsuitable anatomy for percutaneous left atrial appendage (LAA) closure, surgical LAA occlusion was performed. This case highlights the importance of lifelong AF management following successful ASA.
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Akita et al. (2026) conducted a case report in Hypertrophic obstructive cardiomyopathy (n=1). Alcohol septal ablation was evaluated. A 68-year-old man developed recurrent atrial fibrillation four years after successful alcohol septal ablation for hypertrophic obstructive cardiomyopathy, ultimately requiring surgical left atrial appendage occlusion.
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