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Outcomes of Patients With Hypertrophic Obstructive Cardiomyopathy and Pacemaker Implanted After Alcohol Septal Ablation

J. Veselka, M. Liebregts, R. Cooper, L. Faber, J. Januska, M. Kashtanov, KH. Tesarkova, PR. Hansen, H. Seggewiss, E. Shloydo, K. Popov, E. Hansvenclova, J. Bonaventura, JT. Berg, RH. Stables, E. Polakova

. 2022 ; 15 (19) : 1910-1917. [pub] 20220914

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22033099

BACKGROUND: Atrioventricular block is a frequent major complication after alcohol septal ablation (ASA). OBJECTIVES: The aim of this study was to evaluate the outcomes of patients with implanted permanent pacemaker (PPM) related to a high-grade atrioventricular block after ASA for hypertrophic obstructive cardiomyopathy. METHODS: We used a multinational registry (the Euro-ASA registry) to evaluate the outcome of patients with PPM after ASA. RESULTS: A total of 1,814 patients were enrolled and followed up for 5.0 ± 4.3 years (median = 4.0 years). A total of 170 (9.4%) patients underwent PPM implantation during the first 30 days after ASA. Using propensity score matching, 139 pairs (n = 278) constituted the matched PPM and non-PPM groups. Between the matched groups, there were no long-term differences in New York Heart Association functional class (1.5 ± 0.7 vs 1.5 ± 0.9, P = 0.99) and survival (log-rank P = 0.47). Patients in the matched PPM group had lower long-term left ventricular (LV) outflow gradient (12 ± 12 mm Hg vs 17 ± 19 mm Hg, P < 0.01), more pronounced LV outflow gradient decrease (81% ± 17% vs 72% ± 35%, P < 0.01), and lower LV ejection fraction (64% ± 8% vs 66% ± 8%, P = 0.02) and were less likely to undergo reintervention (re-ASA or myectomy) (log-rank P = 0.02). CONCLUSIONS: Patients with hypertrophic obstructive cardiomyopathy treated with ASA have a 9% probability of PPM implantation within 30 days after ASA. In long-term follow-up, patients with PPM had similar long-term survival and New York Heart Association functional class but lower LV outflow gradient, a more pronounced LV outflow gradient decrease, a lower LV ejection fraction, and a lower likelihood of reintervention compared with patients without PPM.

Citace poskytuje Crossref.org

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$a Outcomes of Patients With Hypertrophic Obstructive Cardiomyopathy and Pacemaker Implanted After Alcohol Septal Ablation / $c J. Veselka, M. Liebregts, R. Cooper, L. Faber, J. Januska, M. Kashtanov, KH. Tesarkova, PR. Hansen, H. Seggewiss, E. Shloydo, K. Popov, E. Hansvenclova, J. Bonaventura, JT. Berg, RH. Stables, E. Polakova
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$a BACKGROUND: Atrioventricular block is a frequent major complication after alcohol septal ablation (ASA). OBJECTIVES: The aim of this study was to evaluate the outcomes of patients with implanted permanent pacemaker (PPM) related to a high-grade atrioventricular block after ASA for hypertrophic obstructive cardiomyopathy. METHODS: We used a multinational registry (the Euro-ASA registry) to evaluate the outcome of patients with PPM after ASA. RESULTS: A total of 1,814 patients were enrolled and followed up for 5.0 ± 4.3 years (median = 4.0 years). A total of 170 (9.4%) patients underwent PPM implantation during the first 30 days after ASA. Using propensity score matching, 139 pairs (n = 278) constituted the matched PPM and non-PPM groups. Between the matched groups, there were no long-term differences in New York Heart Association functional class (1.5 ± 0.7 vs 1.5 ± 0.9, P = 0.99) and survival (log-rank P = 0.47). Patients in the matched PPM group had lower long-term left ventricular (LV) outflow gradient (12 ± 12 mm Hg vs 17 ± 19 mm Hg, P < 0.01), more pronounced LV outflow gradient decrease (81% ± 17% vs 72% ± 35%, P < 0.01), and lower LV ejection fraction (64% ± 8% vs 66% ± 8%, P = 0.02) and were less likely to undergo reintervention (re-ASA or myectomy) (log-rank P = 0.02). CONCLUSIONS: Patients with hypertrophic obstructive cardiomyopathy treated with ASA have a 9% probability of PPM implantation within 30 days after ASA. In long-term follow-up, patients with PPM had similar long-term survival and New York Heart Association functional class but lower LV outflow gradient, a more pronounced LV outflow gradient decrease, a lower LV ejection fraction, and a lower likelihood of reintervention compared with patients without PPM.
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$a Liebregts, Max $u Department of Cardiology, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
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$a Cooper, Robert $u Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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$a Faber, Lothar $u Ruhr-University Bochum, Bochum, Germany
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$a Januska, Jaroslav $u Cardiocentre Podlesi, Trinec, Czech Republic
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$a Tesarkova, Klara Hulikova $u Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czech Republic
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$a Hansen, Peter Riis $u Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark
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$a Seggewiss, Hubert $u Comprehensive Heart Failure Centre, University Clinic Wurzburg, Wurzburg, Germany
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$a Shloydo, Eugene $u Department of Cardiology, City Hospital No. 2, Saint-Petersburg, Russian Federation
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$a Popov, Kirill $u Department of Cardiology, City Hospital No. 2, Saint-Petersburg, Russian Federation
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$a Hansvenclova, Eva $u Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic
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$a Bonaventura, Jiri $u Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic
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$a Berg, Jurriën Ten $u Department of Cardiology, St. Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands
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$a Stables, Rodney Hilton $u Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
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$a Polakova, Eva $u Department of Cardiology, Second Medical School, Charles University, University Hospital Motol, Prague, Czech Republic
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