Outcomes of Alcohol Septal Ablation in Patients with Severe Left Ventricular Outflow Tract Obstruction: A Propensity Score Matching Analysis
Abstract
BACKGROUND: The current ACC/AHA guidelines on hypertrophic cardiomyopathy (HCM) caution that alcohol septal ablation (ASA) might be less effective in patients with left ventricular outflow tract obstruction (LVOTO) >=100 mmHg. METHODS: We used a multinational registry to evaluate the outcome of ASA patients according to baseline LVOTO.
RESULTS: A total of 1346 ASA patients were enrolled and followed for 5.8+-4.7 years (7764 patient-years). The patients with baseline LVOTO >=100 mmHg were significantly older (61+-14 years vs. 57+-13 years; p=100 mmHg (82+-21% vs. 73+-26%; p=100 mmHg underwent more re-interventions (p=0.02).
CONCLUSIONS: After propensity matching, ASA patients with baseline LVOTO >=100 mmHg had similar survival and dyspnea (NYHA class) as patients with baseline LVOTO <100 mmHg but their residual LVOTO and risk of repeated procedures were higher.