Efficacy and safety of alcohol septal ablation in patients over 65 years old with obstructive hypertrophic cardiomyopathy
Received 2 October 2016
Accepted for publication 28 October 2016
Published 3 March 2017 Volume 2017:12 Pages 467—473
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Laila Cheddadi,1 Olivier Lairez,1–4 Thibault Lhermusier,1,5 Francisco Campelo-Parada,1 Michel Galinier,1,3,4 Didier Carrié,1,3,5 Nicolas Boudou1
1Department of Cardiology, University Hospital of Rangueil, 2Department of Nuclear Medicine, 3Cardiac Imaging Center, Toulouse University Hospital, 4Medical School of Rangueil, 5Medical School of Purpan, University Paul Sabatier, Toulouse, France
Background: The performance of alcohol septal ablation (ASA) in elderly symptomatic patients with drug-refractory obstructive hypertrophic cardiomyopathy is still to be confirmed. The objective of this study was to compare the efficacy and safety of ASA in patients under and over 65 years old.
Methods and results: Fifty-one consecutive patients with obstructive hypertrophic cardiomyopathy who underwent ASA were retrospectively included and reviewed for in-hospital major acute cardiac events and follow-up. Twenty-eight patients were over 65 years old. Left ventricular outflow tract obstruction at rest, use of diuretic and average dose of diuretic were higher in patients over 65 years old. There was no difference in hospital stay between patients under and over 65 years old. Among patients over 65 years old, 2 (7%) died before being discharged. Major acute cardiac events were more frequent in patients over 65 years old in comparison with younger patients (43% versus 9%, respectively, P=0.007). The average follow-up duration was 16±15 months. There was no difference between patients under and over 65 years old regarding the efficacy of the procedure with a decrease of the New York Heart Association class of 1.3±0.6 and 1.4±0.7 (P=0.510) and the maximum left ventricular outflow tract gradient of 86±57 and 81±36 mmHg (P=0.733), respectively.
Conclusion: Elderly patients have the same benefits as younger patients after ASA but have more complications including mortality events.
Keywords: alcohol septal ablation, hypertrophic cardiomyopathy, elderly
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