Occurrence of de novo sustained monomorphic ventricular tachycardia induced after percutaneous transluminal alcohol septal myocardial ablation for hypertrophic obstructive cardiomyopathy

Hori, Yasuhiko; Ueda, Marehiko; Nakayama, Takashi; Saegusa, Noriko; Uehara, Masae; Lee, Kwang-Ho; Tai, Sheng; Daimon, Masao; Kobayashi, Yoshio; Funabashi, Nobusada; Komuro, Issei

doi:10.1016/j.ijcard.2006.07.182

Cited by 36 publications

(30 citation statements)

References 13 publications

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“…53,296,356 There has been concern that the potential ventricular arrhythmogenicity of the scar created by septal ablation might augment risk in the HCM population. Several studies have documented the occurrence of sustained ventricular arrhythmias 332,349,[357][358][359][360][361][362][363] and SCD following septal ablation 322 in about 3% to 10% of patients both with or without risk factors for SCD. In a single-center experience (nϭ91), 21% of patients experienced sudden or other cardiac death, aborted SCD, and/or appropriate ICD discharge resulting in an annualized event rate of 4.4% per year after ablation.…”

Section: Complicationsmentioning

confidence: 99%

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

et al. 2011

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Section: Complicationsmentioning

confidence: 99%

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

et al. 2011

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“…144,275,324 There has been concern that the potential ventricular arrhythmogenicity of the scar created by septal ablation might augment risk in the HCM population. Several studies have documented the occurrence of sustained ventricular arrhythmias 301,314,[325][326][327][328][329][330][331] and SCD following septal ablation 296 in about 3% to 10% of patients both with or without risk factors for SCD. Patients with HCM considered to carry sufficient risk to warrant ICD placement have an annual incidence of appropriate interventions for VT/ventricular fibrillation of 3% to 10%.…”

Section: Complicationsmentioning

confidence: 99%

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Executive Summary

et al. 2011

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“…8 It is not well known whether this may produce an arrhythmic substrate and possibly trigger sudden cardiac death (SCD). 9,10 Therefore, the present study sought to describe long-term post-ASA outcome.…”

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confidence: 99%

Long-Term Outcome of Alcohol Septal Ablation in Patients With Obstructive Hypertrophic Cardiomyopathy

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Soliman

Michels

et al. 2010

Circ: Heart Failure

191

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Background-The impact of alcohol septal ablation (ASA)-induced scar is not known. This study sought to examine the long-term outcome of ASA among patients with obstructive hypertrophic cardiomyopathy. Methods and Results-Ninety-one consecutive patients (aged 54Ϯ15 years) with obstructive hypertrophic cardiomyopathy underwent ASA. Primary study end point was a composite of cardiac death and aborted sudden cardiac death including appropriate cardioverter-defibrillator discharges for fast ventricular tachycardia/ventricular fibrillation. Secondary end points were noncardiac death and other nonfatal complications. Outcomes of ASA patients were compared with 40 patients with hypertrophic cardiomyopathy who underwent septal myectomy. During 5.4Ϯ2.5 years, primary and/or secondary end points were seen in 35 (38%) ASA patients of whom 19 (21%) patients met the primary end point. The 1-, 5-, and 8-year survival-free from the primary end point was 96%, 86%, and 67%, respectively in ASA patients versus 100%, 96%, and 96%, respectively in myectomy patients during 6.6Ϯ2.7 years (log-rank, Pϭ0.01). ASA patients had a Ϸ5-fold increase in the estimated annual primary end point rate (4.4% versus 0.9%) compared with myectomy patients. In a multivariable model including a propensity score, ASA was an independent predictor of the primary end point (unadjusted hazard ratio, 5.2; 95% CI, 1.2 to 22.1; Pϭ0.02 and propensity score-adjusted hazard ratio, 6.1; 95% CI, 1.4 to 27.1; Pϭ0.02). Conclusions-This study shows that ASA has potentially unwanted long-term effects. This poses special precaution, given the fact that ASA is practiced worldwide at increasing rate. We recommend myectomy as the preferred intervention in patients with obstructive hypertrophic cardiomyopathy. (Circ Heart Fail. 2010;3:362-369.)

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Occurrence of de novo sustained monomorphic ventricular tachycardia induced after percutaneous transluminal alcohol septal myocardial ablation for hypertrophic obstructive cardiomyopathy

Cited by 36 publications

References 13 publications

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Executive Summary

Long-Term Outcome of Alcohol Septal Ablation in Patients With Obstructive Hypertrophic Cardiomyopathy

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