Outcomes of Patients With Hypertrophic Obstructive Cardiomyopathy and Pacemaker Implanted After Alcohol Septal Ablation
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
36202559
DOI
10.1016/j.jcin.2022.06.034
PII: S1936-8798(22)01322-X
Knihovny.cz E-resources
- Keywords
- alcohol septal ablation, permanent pacemaker, prognosis,
- MeSH
- Ablation Techniques * adverse effects MeSH
- Atrioventricular Block * diagnosis etiology therapy MeSH
- Ethanol adverse effects MeSH
- Cardiomyopathy, Hypertrophic * diagnostic imaging surgery MeSH
- Pacemaker, Artificial * MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Heart Septum diagnostic imaging surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Ethanol MeSH
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.
Cardiocentre Podlesi Trinec Czech Republic
Comprehensive Heart Failure Centre University Clinic Wurzburg Wurzburg Germany
Department of Cardiology City Hospital No 2 Saint Petersburg Russian Federation
Department of Cardiology Herlev and Gentofte Hospital Hellerup Denmark
Department of Cardiology St Antonius Hospital Nieuwegein Nieuwegein the Netherlands
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