Outcome of patients >= 60 years of age after alcohol septal ablation for hypertrophic obstructive cardiomyopathy
Abstract
Introduction: The outcome of patients >= 60 years of age after alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) remains unresolved. We sought to determine the long-term survival and the causes of death in this population.
Material and methods: We enrolled 156 consecutive patients (69 +/- 6 years, 69% women, follow-up: 4.8 +/- 3.5 years) who underwent ASA at >= 60 years of age. Results: The 30-day mortality rate was 1.3%.
At the last check-up, 81% of patients were in New York Heart Association class <= 2 and 76% had a left ventricular outflow tract gradient (LVOG) <= 30 mm Hg. A total of 39 patients died (51% of cardiovascular causes, 44% of non-cardiovascular causes, 5% of unknown causes) during the 734 patient-years.
The annual sudden mortality, the sudden mortality and the all-cause mortality rates were 0.5%, 1.1%, and 4.8%, respectively. The all-cause mortality was higher compared to the age- and sex-matched general population (p = 0.002).
Conclusions: Alcohol septal ablation was safe and effective in the long-term follow-up. We observed a reduced life expectancy compared to the age- and sex-matched general population.
Mortality was almost equally due to cardiovascular and non-cardiovascular causes of death.