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 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.
Methods and Results—We examined 177 patients (mean age, 64 yrs; 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 gender-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 to 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 non-randomized 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, as well as to patients who undergo surgical myectomy, without an increased risk of sudden cardiac death.
- Received November 2, 2011.
- Accepted September 24, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited