Abstract
BackgroundThe 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. MethodsWe 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. ResultsThe 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). ConclusionsMatched 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.
Highlights
Catheter-based therapy of hypertrophic obstructive cardiomyopathy (HOCM) was introduced 25 years ago and in the first 3 cases performed by Ulrich Sigwart the dosages of alcohol were 3 ml in one patient and 5 ml in the other two patients [1]
The current guidelines on hypertrophic cardiomyopathy recommend using 1–3 mL of alcohol infused into the target septal perforator artery in controlled fashion [5,6]
We collected data of patients treated with alcohol septal ablation (ASA) in nine experienced European hospital centers, and using propensity score matching analysis, we evaluated their short- and long-term outcomes with regard to procedural dose of alcohol used (1–1.9 mL vs. 2–3.8 mL)
Summary
Catheter-based therapy of HOCM was introduced 25 years ago and in the first 3 cases performed by Ulrich Sigwart the dosages of alcohol were 3 ml in one patient and 5 ml in the other two patients [1]. The current guidelines on hypertrophic cardiomyopathy recommend using 1–3 mL of alcohol infused into the target septal perforator artery in controlled fashion [5,6] This recommendation on alcohol volume is based more on practical experience of interventionalists, rather than on strong, short- and long-term systematic evidence. We collected data of patients treated with ASA in nine experienced European hospital centers, and using propensity score matching analysis, we evaluated their short- and long-term outcomes with regard to procedural dose of alcohol used (1–1.9 mL vs 2–3.8 mL). 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). 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
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
