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Alcohol dose in septal ablation for hypertrophic obstructive cardiomyopathy

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  • Josef Veselka
  • Lothar Faber
  • Max Liebregts
  • Robert Cooper
  • Jaroslav Januska
  • Maksim Kashtanov
  • Maciej Dabrowski
  • Peter Riis Hansen
  • Hubert Seggewiss
  • Jiri Bonaventura
  • Eva Polakova
  • Eva Hansvenclova
  • Henning Bundgaard
  • Jurriën Ten Berg
  • Rodney Hilton Stables
  • Jiri Jarkovsky
  • Morten Kvistholm Jensen
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BACKGROUND: The aim of this study was to evaluate short- and long-term outcomes related to dose of alcohol administered during alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM). Current guidelines recommend using 1-3 mL of alcohol administered in the target septal perforator artery, but this recommendation is based more on practical experience of interventionalists rather than on systematic evidence.

METHODS: We included 1448 patients and used propensity score to match patients who received a low-dose (1.0-1.9 mL) versus a high-dose (2.0-3.8 mL) of alcohol during ASA.

RESULTS: The matched cohort analysis comprised 770 patients (n = 385 in both groups). There was a similar occurrence of 30-day post-procedural adverse events (13% vs. 12%; p = 0.59), and similar all-cause mortality rates (0.8% vs. 0.5%; p = 1) in the low-dose group and the high-dose group, respectively. In the long-term follow-up (5.4 ± 4.5 years), a total of 110 (14%) patients died representing 2.58 deaths and 2.64 deaths per 100 patient-years in the low dose and the high dose group (logrank, p = 0.92), respectively. There were no significant differences in the long-term dyspnea and left ventricular outflow gradient between the two groups. Patients treated with a low-dose of alcohol underwent more subsequent septal reduction procedures (logrank, p = 0.04).

CONCLUSIONS: Matched HOCM patients undergoing ASA with a low-dose (1.0-1.9 mL) or a high-dose (2.0-3.8 mL) of alcohol had similar short- and long-term outcomes. A higher rate of repeated septal reduction procedures was observed in the group treated with a low-dose of alcohol.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume333
Pages (from-to)127-132
Number of pages6
ISSN0167-5273
DOIs
Publication statusPublished - 15 Jun 2021

Bibliographical note

Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.

    Research areas

  • Ablation Techniques, Cardiomyopathy, Hypertrophic/diagnostic imaging, Catheter Ablation, Ethanol, Heart Septum/diagnostic imaging, Humans, Retrospective Studies, Treatment Outcome

ID: 71923387