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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

Anna Axelsson1, Kristina Weibring, Ole Havndrup

  • 1aDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet & The University of Copenhagen bDepartment of Cardiology, Roskilde Sygehus, Roskilde, Denmark.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|March 26, 2014
PubMed

Insights

Alcohol septal ablation for hypertrophic cardiomyopathy can cause heart block. Some patients experience normalized heart conduction years later, particularly those without baseline PR interval prolongation or acute heart block during the procedure.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Interventions

Background:

  • Alcohol septal ablation (ASA) is used for obstructive hypertrophic cardiomyopathy (HCM).
  • Atrioventricular (AV) conduction system damage is a known complication of ASA.
  • Long-term outcomes of AV conduction after ASA require further investigation.

Purpose of the Study:

  • To assess long-term atrioventricular conduction in patients following alcohol septal ablation.
  • To identify predictors of persistent atrioventricular block after ASA.

Main Methods:

  • Prospective ECG and Holter monitoring in pacemaker patients post-ASA.
  • Retrospective analysis of AV conduction in non-pacemaker patients.
  • Comparison of baseline characteristics between patients with and without persistent AV block.

Main Results:

  • 28% of patients developed high-grade AV block requiring pacemakers after ASA.
  • In 14 pacemaker patients followed long-term (mean 6.2 years), 6 showed normalized AV conduction.
  • Baseline PR interval ≥200ms and acute complete heart block during ASA predicted higher risk of persistent AV block.

Conclusions:

  • Long-term recovery of AV conduction is possible in some patients after ASA.
  • Baseline PR interval and acute procedural events are crucial in predicting persistent AV block.
  • ASA requires careful consideration of AV conduction risks in obstructive HCM patients.
Abstract

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