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Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry.

Publication ,  Journal Article
Nagueh, SF; Groves, BM; Schwartz, L; Smith, KM; Wang, A; Bach, RG; Nielsen, C; Leya, F; Buergler, JM; Rowe, SK; Woo, A; Maldonado, YM; Spencer, WH
Published in: Journal of the American College of Cardiology
November 2011

The purpose of the study is to identify the predictors of clinical outcome (mortality and survival without repeat septal reduction procedures) of alcohol septal ablation for the treatment of patients with hypertrophic obstructive cardiomyopathy.Alcohol septal ablation is used for treatment of medically refractory hypertrophic obstructive cardiomyopathy patients with severe outflow tract obstruction. The existing literature is limited to single-center results, and predictors of clinical outcome after ablation have not been determined. Registry results can add important data.Hypertrophic obstructive cardiomyopathy patients (N = 874) who underwent alcohol septal ablation were enrolled. The majority (64%) had severe obstruction at rest, and the remaining had provocable obstruction. Before ablation, patients had severe dyspnea (New York Heart Association [NYHA] functional class III or IV: 78%) and/or severe angina (Canadian Cardiovascular Society angina class III or IV: 43%).Significant improvement (p < 0.01) occurred after ablation (~5% in NYHA functional classes III and IV, and 8 patients in Canadian Cardiovascular Society angina class III). There were 81 deaths, and survival estimates at 1, 5, and 9 years were 97%, 86%, and 74%, respectively. Left anterior descending artery dissections occurred in 8 patients and arrhythmias in 133 patients. A lower ejection fraction at baseline, a smaller number of septal arteries injected with ethanol, a larger number of ablation procedures per patient, a higher septal thickness post-ablation, and the use beta-blockers post-ablation predicted mortality.Variables that predict mortality after ablation, include baseline ejection fraction and NYHA functional class, the number of septal arteries injected with ethanol, post-ablation septal thickness, beta-blocker use, and the number of ablation procedures.

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Published In

Journal of the American College of Cardiology

DOI

EISSN

1558-3597

ISSN

0735-1097

Publication Date

November 2011

Volume

58

Issue

22

Start / End Page

2322 / 2328

Related Subject Headings

  • Ventricular Outflow Obstruction
  • Ultrasonography, Interventional
  • Stroke Volume
  • Registries
  • North America
  • Middle Aged
  • Male
  • Humans
  • Heart Septum
  • Female
 

Citation

APA
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ICMJE
MLA
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Nagueh, S. F., Groves, B. M., Schwartz, L., Smith, K. M., Wang, A., Bach, R. G., … Spencer, W. H. (2011). Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry. Journal of the American College of Cardiology, 58(22), 2322–2328. https://doi.org/10.1016/j.jacc.2011.06.073
Nagueh, Sherif F., Bertron M. Groves, Leonard Schwartz, Karen M. Smith, Andrew Wang, Richard G. Bach, Christopher Nielsen, et al. “Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry.Journal of the American College of Cardiology 58, no. 22 (November 2011): 2322–28. https://doi.org/10.1016/j.jacc.2011.06.073.
Nagueh SF, Groves BM, Schwartz L, Smith KM, Wang A, Bach RG, et al. Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry. Journal of the American College of Cardiology. 2011 Nov;58(22):2322–8.
Nagueh, Sherif F., et al. “Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry.Journal of the American College of Cardiology, vol. 58, no. 22, Nov. 2011, pp. 2322–28. Epmc, doi:10.1016/j.jacc.2011.06.073.
Nagueh SF, Groves BM, Schwartz L, Smith KM, Wang A, Bach RG, Nielsen C, Leya F, Buergler JM, Rowe SK, Woo A, Maldonado YM, Spencer WH. Alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy. A multicenter North American registry. Journal of the American College of Cardiology. 2011 Nov;58(22):2322–2328.
Journal cover image

Published In

Journal of the American College of Cardiology

DOI

EISSN

1558-3597

ISSN

0735-1097

Publication Date

November 2011

Volume

58

Issue

22

Start / End Page

2322 / 2328

Related Subject Headings

  • Ventricular Outflow Obstruction
  • Ultrasonography, Interventional
  • Stroke Volume
  • Registries
  • North America
  • Middle Aged
  • Male
  • Humans
  • Heart Septum
  • Female