Long-Term Effects of Varying Alcohol Dosing in Percutaneous Septal Ablation for Obstructive Hypertrophic Cardiomyopathy: A Randomized Study With a Follow-up up to 11 Years

Outcomes of alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a European multicentre and multinational study

“…Although acceptable outcomes of several single-centre studies have led to the increased use of ASA, mainly in Europe, there remains a need for multicenter and multinational experience regarding the efficacy and safety of ASA and the prediction of clinical and hemodynamic procedural success. Moreover, we hypothesized that early outcomes of ASA patients are better than was reported in observations from the first decade after ASA introduction [5][6][7][8][9][10][11][12][13][14][15][16]. Therefore, we herein report the experience of this multicenter study.…”

The long‐term outcomes of transcoronary ablation of septal hypertrophy compared to surgical myectomy in patients with symptomatic hypertrophic obstructive cardiomyopathy

“…The optimum site is the proximal septal bulge, the site at which systolic anterior motion of the mitral valve is triggered and where acceleration of blood through the outflow tract is most increased. Over the course of the study, the volume of alcohol injected changed from 2 cc or more to less a 1 cc in line with changes in clinical practice demonstrating less heart block and similar reductions in outflow tract gradient with lower alcohol volumes . The average volume of alcohol injected over the study period was 1.8 mL (0.4–4.0 mL), prior to December 2003 the average volume was 2.9 mL (2.5–4.0), and after 1.2 mL (0.4–3.0 mL) ( P < 0.001).…”

Non-surgical septal reduction therapy in hypertrophic cardiomyopathy

“…No significant difference in outcome was observed between the high-dose and low-dose injections 49. The recent Euro-ASA registry suggested a higher dose of alcohol has a greater effect on LVOT gradients; a dose of <1.5 mL fails to make a significant impact on LVOT gradient in 20% of patients, whereas a dose of >3 mL fails to impact gradient in 10% of patients.…”

“…Some series have reported a loose correlation of alcohol to cardiac enzyme release (as a marker of infarct size),49 and others show no meaningful correlation 44…”