Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy: A long-term follow-up study based on the Euro-alcohol septal ablation registry

Background- the long-term efficacy and safety of alcohol septal ablation (asa) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. the aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive cardiomyopathy treated with asa. methods and results- we retrospectively evaluated consecutive patients enrolled in the euro-asa registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (new york heart association [nyha] class ii) pre-asa. the median (interquartile range) follow-up was 4.8 (1.7-8.5) years. the clinical outcome was assessed and compared with the age- and sex-matched general population. the 30-day mortality after asa was 0.6% and the annual all-cause mortality rate was 1.7%,which was similar to the age- and sex-matched general population (p=0.62). a total of 141 (88%) patients had resting left ventricular outflow tract gradient at the last clinical checkup ≤30 mm hg. obstruction was reduced from 63±32 to 15±19 mm hg (p < 0.01),and the mean nyha class decreased from 2.0±0 to 1.3±0.1 (p < 0.01); 69%,29%,and 2% of patients were in nyha class i,ii,and iii at the last clinical checkup,respectively. conclusions- mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with asa had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. their survival is comparable to the general population. © 2017 the authors.