| Is alcohol ablation of the septum associated with recurrent tachyarrhythmias? | |
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MedLine Citation:
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PMID: 18058274 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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QUESTIONS UNDER STUDY: Alcohol ablation (AA) of the septum has been introduced as new therapy in hypertrophic cardiomyopathy (HCM). It was feared that iatrogenic myocardial infarction due to AA may induce re-entry tachyarrhythmias and increase sudden cardiac death. METHODS AND RESULTS: Twenty-four patients (mean age 52 years) underwent successful AA. Clinical follow-up (FU) ranged from 0.3 to 0.7 years (mean 2.8). One patient died (suicide) 4 years after AA. Left ventricular (LV) outflow gradient (peak-to-peak) decreased (median) after AA from 43 (IQR 25 to 4) mmHg to 1 (IQR 0 to 12) mmHg (rest) (p <0.001) and from 130 (IQR 75 to 165) mmHg to 13 (IQR 0 to 31) mmHg (postextrasystolic) (p <0.001). Transient AV block occurred in 22% (5/24) necessitating temporary pacing. A permanent pacemaker was implanted in 4% (1/24). NYHA-class was 2.5 (IQR 2.0 to 3.0) before and 1.5 (IQR 1.3 to 2.0) (p <0.001) after AA. During FU, 2 pacemakers were implanted due to bradycardia (no AV block). A right bundle branch block was found in 13% (2/24) before and 46 % (11/24) after AA (p = 0.003). Non-sustained ventricular tachycardia (NSVT) was observed in 13% (2/16) before and 22% (5/23) (p = 0.46) after AA. Two patients required ICD implantation. CONCLUSIONS: Long-term FU is excellent in HCM after AA. The pressure gradient drops below 25 mm Hg in 95% (23/24) of all patients. Transient AV block occurs in 22% (5/24), but permanent pacemaker implantation is rarely needed (13%, 2/24). Severe NSVT occurs in 13% (2/16) before and 22% (5/23) after AA but ICD implantation is only occasionally required. |
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Authors:
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Sven Streit; Nazan Walpoth; Stephan Windecker; Bernhard Meier; Otto Hess |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Swiss medical weekly Volume: 137 ISSN: 1424-7860 ISO Abbreviation: Swiss Med Wkly Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-06 Completed Date: 2008-02-01 Revised Date: 2011-02-15 |
Medline Journal Info:
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Nlm Unique ID: 100970884 Medline TA: Swiss Med Wkly Country: Switzerland |
Other Details:
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Languages: eng Pagination: 660-8 Citation Subset: IM |
Affiliation:
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Swiss Cardiovascular Center, University Hospital, Inselspital, Berne, Switzerland. svenstreit@bluewin.ch |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cardiomyopathy, Hypertrophic / surgery Catheter Ablation / methods* Echocardiography Ethanol / administration & dosage* Female Heart Septum / surgery* Humans Male Middle Aged Outcome Assessment (Health Care) Recurrence Switzerland Tachycardia / surgery* |
| Chemical | |
Reg. No./Substance:
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64-17-5/Ethanol |
| Comments/Corrections | |
Comment In:
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Swiss Med Wkly. 2008 May 31;138(21-22):322; author reply 322-3
[PMID:
18578089
]
Swiss Med Wkly. 2007 Dec 1;137(47-48):657-9 [PMID: 18058273 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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