Risk and Causes of Death in Patients After Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
26095933
DOI
10.1016/j.cjca.2015.02.010
PII: S0828-282X(15)00124-5
Knihovny.cz E-resources
- MeSH
- Alcohols therapeutic use MeSH
- Survival Analysis MeSH
- Time Factors MeSH
- Defibrillators, Implantable MeSH
- Electric Countershock methods mortality MeSH
- Cardiomyopathy, Hypertrophic * diagnosis mortality surgery MeSH
- Cicatrix * etiology mortality pathology MeSH
- Catheter Ablation * adverse effects methods mortality MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospital Mortality MeSH
- Myocardium pathology MeSH
- Death, Sudden, Cardiac etiology prevention & control MeSH
- Follow-Up Studies MeSH
- Cause of Death MeSH
- Aged MeSH
- Sclerosing Solutions therapeutic use MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic epidemiology MeSH
- Poland epidemiology MeSH
- Austria epidemiology MeSH
- Names of Substances
- Alcohols MeSH
- Sclerosing Solutions MeSH
BACKGROUND: Because the final myocardial scar might be theoretically associated with an increased risk of sudden cardiac death, the long-term clinical course of patients who undergo alcohol septal ablation (ASA) is still a matter of debate. In this retrospective multicentre study, we report outcomes after ASA, including survival, analysis of causes of deaths, and association between time and cause of death. METHODS: We enrolled 366 consecutive patients (58 ± 12 years, 54% women) who were treated using ASA and followed-up for 5.1 ± 4.5 years. RESULTS: The in-hospital and 30-day mortality were 0.5% and 0.8%, respectively; the ASA-related morbidity was < 20%. Overall, 52 patients died during 1867 patient-years, which means the all-cause mortality rate was 2.8% per year. The mortality rates of sudden death and sudden death with an appropriate implantable cardioverter-defibrillator (ICD) discharge were 0.4% and 1% per year, respectively. Patients with sudden death or appropriate ICD discharge experienced these mortality events at younger age than patients who died of other hypertrophic obstructive cardiomyopathy-related causes (60.8 years [range, 52-71.5 years] vs 72.4 years [range, 64.2-75.2 years]; P = 0.048). A total of 292 patients (80%) had an outflow gradient ≤ 30 mm Hg, and 327 patients (89%) were in New York Heart Association class ≤ II at the last clinical check-up. CONCLUSIONS: ASA had low procedure-related mortality, with subsequent 1% occurrence of sudden mortality events per year and 2.8% mortality rate per year in the long-term follow-up. Patients with sudden death or ICD discharge experienced the mortality events approximately 1 decade earlier than patients who died from other causes not related to hypertrophic cardiomyopathy.
Cardiocentre Podlesí Třinec Czech Republic
Department of Interventional Cardiology and Angiology Institute of Cardiology Warsaw Poland
References provided by Crossref.org