Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy.
BACKGROUND
The clinical efficacy of alcohol septal ablation for obstructive hypertrophic cardiomyopathy (HCM) has been demonstrated, but the long-term effects of the procedure remain uncertain. This study examined the survival of patients after septal ablation performed in a tertiary HCM referral center.


RESULTS
We examined 177 patients (mean age, 64 years; 68% women) who underwent septal ablation at our institution. Over a follow-up of 5.7 years, survival free of all mortality was no different than the expected survival for a comparable general population, and similar to that of age- and sex-matched patients who underwent isolated surgical myectomy (8-year survival estimate, 79% versus 79%; P=0.64). For the end point of documented sudden cardiac death or unknown cause of death, the incidence per 100 person-year follow-up was 1.31 (95% confidence interval, 0.60-2.38). Residual left ventricular outflow tract gradient after ablation was an independent predictor of long-term survival free of any death.


CONCLUSIONS
In this nonrandomized study of carefully selected patients undergoing septal ablation by experienced operators in a tertiary referral HCM center, long-term survival was favorable and similar to that of an age- and sex-matched general population, and to patients undergoing surgical myectomy, as well, without an increased risk of sudden cardiac death.
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. paul.sorajja@mayo.edu
Paul
P
Sorajja
Steve R
SR
Ommen
David R
DR
Holmes
Joseph A
JA
Dearani
Charanjit S
CS
Rihal
Bernard J
BJ
Gersh
Ryan J
RJ
Lennon
Rick A
RA
Nishimura
D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality* / Q000601:surgery*; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D000431:Ethanol; D005260:Female; D005500:Follow-Up Studies; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome
D000431:Ethanol