title: Survival of patients ≤ 50 years of age after alcohol septal ablation for hypertrophic obstructive cardiomyopathy.
abstract: BACKGROUND
  The long-term efficacy and safety of alcohol septal ablation (ASA) has recently been demonstrated. However, there is still debate about the outcome of younger patients who should be treated using myectomy, according to American College of Cardiology Foundation/American Heart Association guidelines. The aim of this study was to evaluate the long-term outcome of patients ≤ 50 years of age after ASA for hypertrophic obstructive cardiomyopathy (HOCM).
  
  
  METHODS
  We retrospectively evaluated consecutive, highly symptomatic patients aged ≤ 50 years with HOCM who underwent ASA.
  
  
  RESULTS
  Institutional databases of 3 cardiovascular centres identified 290 patients with HOCM who underwent ASA; 75 (26%) of them were aged ≤ 50 years at the time of their first ASA. Median duration of follow-up was 5.1 years (range, 0.1-15.4 years). Four patients (5%) died during the study period (438 patient-years; the annual mortality rate was 0.91%; 95% confidence interval [CI], 0.25-2.34%; the annual mortality rate combined with the first appropriate implantable cardioverter-defibrillator discharge was 1.43%; 95% CI, 0.52-3.10%). Survival free of all-cause mortality at 1, 5, and 10 years was 97% (95% CI, 89-99%), 94% (95% CI, 84-98%), and 94% (95% CI, 84-98%), respectively.
  
  
  CONCLUSIONS
  Results of this first study focused on HOCM patients aged ≤ 50 years who underwent ASA suggest a low risk of all-cause death or appropriate implantable cardioverter-defibrillator discharge in the long-term follow-up.
authors.affiliation: Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic. Electronic address: veselka.josef@seznam.cz.
authors.forename: Josef
authors.initials: J
authors.lastname: Veselka
authors.affiliation: First Department of Internal Medicine/Cardioangiology, Masaryk University, International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Krejčí
authors.affiliation: Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic.
authors.forename: Pavol
authors.initials: P
authors.lastname: Tomašov
authors.affiliation: Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic.
authors.forename: Denisa
authors.initials: D
authors.lastname: Jahnlová
authors.affiliation: First Department of Internal Medicine/Cardioangiology, Masaryk University, International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Honěk
authors.affiliation: Cardiocenter Trinec, Hospital Podlesi, Trinec, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Januška
authors.affiliation: Cardiocenter Trinec, Hospital Podlesi, Trinec, Czech Republic.
authors.forename: Marian
authors.initials: M
authors.lastname: Branny
authors.affiliation: Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic.
authors.forename: David
authors.initials: D
authors.lastname: Zemánek
mesh_terms: D055011:Ablation Techniques; D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000401:mortality* / Q000601:surgery*; D018153:Czech Republic / Q000453:epidemiology; D003645:Death, Sudden / Q000453:epidemiology*; D017147:Defibrillators, Implantable; D000431:Ethanol / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D012997:Solvents / Q000008:administration & dosage; D020521:Stroke / Q000401:mortality*; D054088:Ventricular Septum / Q000601:surgery
chemical_list: D012997:Solvents; D000431:Ethanol