Incidence and Predictors of Late Complete Heart Block After Alcohol Septal Ablation Treatment of Hypertrophic Obstructive Cardiomyopathy

Abstract

Late CHB is a common complication of ASA for treatment of symptomatic HCM. Post-discharge electrocardiographic surveillance for atrioventricular conduction disease should be considered after ASA, especially for those with a high provokable LVOT gradient.

Incidence of Atrial Fibrillation following Alcohol Septal Ablation for Hypertrophic Cardiomyopathy

“…Prior to the procedure, all patients had symptoms attributable to LVOT obstruction with a mean NYHA class of 2.9 ± 0.4, which on follow‐up improved significantly to 1.3 ± 0.5 (change = –1.6, P < 0.001). We previously described the complications and longitudinal echocardiographic indices that persisted after the ASA procedure , but we reanalyzed these same parameters for this subset of patients who did not have AF at baseline.…”

The role of electrophysiologic study in high‐risk patients with new‐onset conduction disturbances following alcohol septal ablation for hypertrophic obstructive cardiomyopathy

“…Conduction system abnormalities including heart block are common following alcohol septal ablation (ASA) for symptomatic hypertrophic obstructive cardiomyopathy, with up to 15% of patients receive a permanent pacemaker (PPM) 1,2 . Prolonged monitoring and/or prophylactic temporary pacemaker (PM) placement are frequently used in patients with new‐onset right bundle branch block (RBBB) or periprocedural transient complete heart block (CHB) after ASA 3,4 . There are no guidelines for risk stratification or treatment of these patients, so management varies widely with no consensus for evaluation.…”

“…1,2 Prolonged monitoring and/or prophylactic temporary pacemaker (PM) placement are frequently used in patients with new-onset right bundle branch block (RBBB) or periprocedural transient complete heart block (CHB) after ASA. 3,4 There are no guidelines for risk stratification or treatment of these patients, so management varies widely with no consensus for evaluation. Electrophysiology study (EPS) has traditionally be used to assess heart block risk in several high-risk patients cohorts, 4 but such an approach has only be studied for intraprocedural recording during ASA.…”

Septal Atrioventricular Junction Region: Comprehensive Imaging in Adults

“…The bundle of His can also be damaged by sutures during repair of the inferior border of a perimembranous ventricular septal defect. Other examples of damage to the bundle branches include myocardial infarct involving the base of the interventricular septum and damage after percutaneous ablation of the septal artery with alcohol for treatment of hypertrophic cardiomyopathy (50). Lesions near the medial papillary muscle can damage the right bundle branch (ie, cardiac sarcoidosis).…”