Interv Akut Kardiol. 2014;13(4):172-176

Long-term effectivity and safety of alcohol septal ablation based on the amount of applied alcohol

Jaroslav Januška, Ivana Holotňáková, Libor Škňouřil, Miroslav Dorda, Bronislav Holek, Marian Branny, Martin Pleva

Kardiocentrum Nemocnice Třinec Podlesí

Introduction: Catheter alcohol septal ablation (ASA) is an effective treatment of patients with symptomatic hypertrophic cardiomyopathy

associated with left ventricle outflow tract obstruction (HOCM). Currently, there is a lack of data describing the long-term effectivity of

ASA after ultra-low dose of alcohol (≤ 1 ml).

Aim: To assess the effect of ASA based on the amount of applied alcohol in long-term follow-up.

Methods: The prospective cohort of 84 consecutive patients with the average age of 59 ± 4.2 years (62 % females) was divided into two groups.

Group A, 31 patients treated with ≤ 1 ml of alcohol and Group B, 53 patients with >1 ml of alcohol. In all patients the clinical and echocardiographic

evaluation was performed during 33 months on average. The amount of myocardial necrosis was assessed by the peak value of CK-MB.

Results: ASA was associated with significant decrease of dyspnoea (NYHA 2.87 vs. 1.74, p < 0.001) and maximal resting gradient (67.2 torr

vs. 23.3 torr, p < 0.001) at 1 year and during follow-up. The amount of myocardial necrosis was lower in Group A (p < 0.001). Better longterm

survival was found in Group B (p < 0.001).

Conclusion: ASA with ultra-low dose of alcohol ≤ 1 ml represent an effective treatment of patients with symptomatic HOCM and is associated

with lower myocardial necrosis.

Keywords: hypertrophic cardiomyopathy, alcoholic septal ablation, midterm results

Published: December 1, 2014  Show citation