BACKGROUND: The clinical efficacy of alcohol septal ablation for obstructive hypertrophic cardiomyopathy (HCM) has been demonstrated, but the long-term effects of the procedure remain uncertain. This study examined the survival of patients after septal ablation performed in a tertiary HCM referral center. METHODS AND RESULTS: We examined 177 patients (mean age, 64 years; 68% women) who underwent septal ablation at our institution. Over a follow-up of 5.7 years, survival free of all mortality was no different than the expected survival for a comparable general population, and similar to that of age- and sex-matched patients who underwent isolated surgical myectomy (8-year survival estimate, 79% versus 79%; P=0.64). For the end point of documented sudden cardiac death or unknown cause of death, the incidence per 100 person-year follow-up was 1.31 (95% confidence interval, 0.60-2.38). Residual left ventricular outflow tract gradient after ablation was an independent predictor of long-term survival free of any death. CONCLUSIONS: In this nonrandomized study of carefully selected patients undergoing septal ablation by experienced operators in a tertiary referral HCM center, long-term survival was favorable and similar to that of an age- and sex-matched general population, and to patients undergoing surgical myectomy, as well, without an increased risk of sudden cardiac death.
BACKGROUND: The clinical efficacy of alcohol septal ablation for obstructive hypertrophic cardiomyopathy (HCM) has been demonstrated, but the long-term effects of the procedure remain uncertain. This study examined the survival of patients after septal ablation performed in a tertiary HCM referral center. METHODS AND RESULTS: We examined 177 patients (mean age, 64 years; 68% women) who underwent septal ablation at our institution. Over a follow-up of 5.7 years, survival free of all mortality was no different than the expected survival for a comparable general population, and similar to that of age- and sex-matched patients who underwent isolated surgical myectomy (8-year survival estimate, 79% versus 79%; P=0.64). For the end point of documented sudden cardiac death or unknown cause of death, the incidence per 100 person-year follow-up was 1.31 (95% confidence interval, 0.60-2.38). Residual left ventricular outflow tract gradient after ablation was an independent predictor of long-term survival free of any death. CONCLUSIONS: In this nonrandomized study of carefully selected patients undergoing septal ablation by experienced operators in a tertiary referral HCM center, long-term survival was favorable and similar to that of an age- and sex-matched general population, and to patients undergoing surgical myectomy, as well, without an increased risk of sudden cardiac death.
Authors: Angelos G Rigopoulos; Muhammad Ali; Elena Abate; Marios Matiakis; Hannes Melnyk; Sophie Mavrogeni; Dionyssios Leftheriotis; Boris Bigalke; Michel Noutsias Journal: Heart Fail Rev Date: 2019-05 Impact factor: 4.214
Authors: Robbert C Steggerda; Christiane A Geluk; Wessel Brouwer; Albert C van Rossum; Jurriën M Ten Berg; Maarten P van den Berg Journal: Int J Cardiovasc Imaging Date: 2015-02-01 Impact factor: 2.357
Authors: Carey Kimmelstiel; David C Zisa; Johny S Kuttab; Sophie Wells; James E Udelson; Benjamin S Wessler; Hassan Rastegar; Navin K Kapur; Andrew R Weintraub; Barry J Maron; Martin S Maron; Ethan J Rowin Journal: Circ Cardiovasc Interv Date: 2019-07-12 Impact factor: 6.546