Survival After Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy

Study Questions:

What is the survival of patients after septal ablation for obstructive hypertrophic cardiomyopathy performed in a tertiary referral center?


The authors examined 177 patients (mean age, 64 years; 68% women) who underwent septal ablation at their institution. Survival comparisons between groups were made by using a Cox model stratified by matched pairs.


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% vs. 79%; p = 0.64). For the endpoint 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.


The authors concluded that the long-term survival after septal ablation was favorable and similar to that of an age- and sex-matched general population, and to patients undergoing surgical myectomy.


This tertiary referral single-center study reported that long-term survival after septal ablation is similar to the expected survival for a similar general US population, and comparable to age- and sex-matched patients who underwent isolated surgical myectomy. It appears that septal ablation in carefully selected patients can result in durable relief of symptoms in the majority of surviving patients at follow-up, without an increased risk of sudden cardiac death. Overall, these data support the role of septal ablation in the management of patients with drug-refractory symptoms due to obstructive hypertrophic cardiomyopathy when performed by experienced operators.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Tertiary Care Centers, Incidence, Follow-Up Studies, Heart Septum, Ethanol, Referral and Consultation, Cardiomyopathy, Hypertrophic, Confidence Intervals, Catheter Ablation, Heart Ventricles, Death, Sudden, Cardiac

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