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Long-term survival after alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a comparison with

Josef Veselka1, Jan Krejčí2, Pavol Tomašov3

  • 1Department of Cardiology, 2nd Medical School, Charles University, University Hospital Motol, Prague, Czech Republic veselka.josef@seznam.cz.

European Heart Journal
|January 28, 2014
PubMed

Insights

Alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM) offers long-term survival comparable to the general population. Age at the time of ASA was the only independent predictor of mortality in these patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic heart condition characterized by thickening of the heart muscle.
  • Alcohol septal ablation (ASA) is a minimally invasive procedure used to treat symptomatic HOCM by reducing the obstructive pressure gradient.
  • Long-term survival data after ASA are crucial for understanding the procedure's overall impact on patient outcomes.

Purpose of the Study:

  • To determine the long-term survival rates of patients who underwent alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM).
  • To compare the survival of these patients with the age- and sex-matched general population.
  • To identify predictors of mortality following ASA in HOCM patients.

Main Methods:

  • A cohort of 178 highly symptomatic HOCM patients treated with ASA between 1998 and 2013 were followed for a median of 4.8 years.
  • Survival data were analyzed and compared to expected survival rates in the general population.
  • Multivariate analysis was performed to identify independent predictors of all-cause mortality.

Main Results:

  • The procedure significantly reduced the left ventricular outflow tract gradient.
  • A total of 19 deaths occurred over 925 patient-years, resulting in an annual mortality rate of 2.1%.
  • One-, 5-, and 10-year survival rates were 97%, 92%, and 82%, respectively, comparable to the general population.
  • Age at the time of ASA was the sole independent predictor of all-cause mortality.

Conclusions:

  • Alcohol septal ablation (ASA) provides long-term survival for patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) that is not significantly different from the general population.
  • The findings support ASA as a viable treatment option for carefully selected HOCM patients.
  • Patient age at the time of ASA is a critical factor influencing long-term outcomes.
Abstract

Keywords:
Alcohol septal ablationHypertrophic cardiomyopathyPrognosis

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