PMID- 26136275
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20161230
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 27
IP  - 7
DP  - 2015 Jul
TI  - Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: Safe and 
      Apparently Efficacious But Does Reporting of Aggregate Outcomes Hide 
      Less-Favorable Results, Experienced by a Substantial Proportion of Patients?
PG  - 301-8
AB  - AIMS: To describe individual and aggregate outcomes for patients undergoing 
      alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM). 
      METHODS: Retrospective case series reviewing all patients undergoing ASA at a 
      United Kingdom tertiary referral center from 2000-2012. Aggregate and individual 
      outcomes are described in terms of symptomatic and hemodynamic response. RESULTS: 
      Eighty-eight patients were reviewed. Alcohol was delivered in 84, with clinical 
      status data available in 82 and hemodynamic data available in 74. All patients 
      had resting or exercise stress left ventricular outflow tract (LVOT) gradient >50 
      mm Hg. Mean age was 60.3 +/- 14.3 years. Follow-up period was 4.2 +/- 3.3 years. 
      Twenty-four patients (27%) required >/=2 procedures. Complete heart block was 
      observed in 17%. New York Heart Association (NYHA) class pre ASA was 2.80 +/- 0.46, 
      improving to 1.92 +/- 0.84 post ASA (P<.001). Fifty-eight out of 82 patients (71%) 
      had improved NYHA class. Resting peak gradient was 99.80 +/- 45.86 mm Hg. Post-ASA 
      peak gradient fell to 23.77 +/- 41.87 mm Hg (P<.001). Sixty-one out of 74 patients 
      (82%) had successful treatment of LVOT gradient. A successful outcome in both 
      symptomatic and gradient treatment was seen in 66% of patients. No patient who 
      received alcohol suffered sudden cardiac death. Fifteen patients had implantable 
      cardioverter defibrillator implantation; no appropriate therapy was delivered. 
      CONCLUSIONS: ASA is safe, with few major complications. Aggregate outcomes are 
      good, but can hide individual failure. There is a need to refine case selection, 
      procedure planning, and performance to secure more uniform favorable outcomes.
FAU - Cooper, Robert M
AU  - Cooper RM
AD  - Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE, United 
      Kingdom. robcooper@doctors.org.uk.
FAU - Shahzad, Adeel
AU  - Shahzad A
FAU - McShane, James
AU  - McShane J
FAU - Stables, Rodney H
AU  - Stables RH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - 3K9958V90M (Ethanol)
SB  - IM
CIN - J Invasive Cardiol. 2015 Jul;27(7):308-10. PMID: 26136276
MH  - Cardiac Surgical Procedures/adverse effects/*methods
MH  - Cardiomyopathy, Hypertrophic/diagnosis/mortality/*surgery
MH  - Catheter Ablation/*methods
MH  - Echocardiography
MH  - Ethanol/*therapeutic use
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - *Forecasting
MH  - Heart Septum/diagnostic imaging/*surgery
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Tachycardia, Ventricular/diagnosis/*epidemiology/etiology
MH  - United Kingdom/epidemiology
EDAT- 2015/07/03 06:00
MHDA- 2016/12/15 06:00
CRDT- 2015/07/03 06:00
PHST- 2015/07/03 06:00 [entrez]
PHST- 2015/07/03 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2015 Jul;27(7):301-8.