Alcohol septal ablation for hypertrophic obstructive cardiomyopathy

Summary

Percutaneous septal ablation has emerged as an interventional treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). In the past decades, the availability of this sophisticated technique has revived the interest of cardiologists in left ventricular outflow tract obstruction, which has led to the recognition that about 70% of the patients with hypertrophic cardiomyopathy (HCM) have dynamic obstruction. Follow-up studies have already shown the safety and efficacy of the procedure, which offers symptomatic relief in most patients. Long-term survival is comparable to historical reports after surgical myectomy. Complications are rare and can be further reduced by an increase in the experience of the operators, while the theoretical concern for possible ventricular arrhythmogenicity caused by the myocardial scar has not been documented by the existing data. In experienced centers percutaneous septal ablation is a viable and safe treatment option for patients with HOCM.

Introduction

Hypertrophic cardiomyopathy (HCM) is a primary myocardial disorder which is clinically defined by the presence of left ventricular hypertrophy unexplained by abnormal loading conditions 1, 2