Sudden cardiac death complicating alcohol septal ablation: A case report and review of literature

Abstract

Over the years, alcohol septal ablation has become an effective and well-accepted modality in the treatment of patients with hypertrophic obstructive cardiomyopathy refractory to standard medical therapy. Malignant tachyarrythmias infrequently complicates the procedure and are usually self-terminating. We describe a case of alcohol septal ablation complicated by sudden cardiac death occurring immediately following the procedure requiring prolonged resuscitative efforts with eventual complete recovery. We also discuss the pathophysiologic significance of this event in the setting of this cardiomyopathy and its relevance as a complication of the procedure.

Complications of low‐dose, echo‐guided alcohol septal ablation

“…Sustained ventricular tachycardia has been rarely reported following the ASA and only few reports described it as an early post‐procedural complication [8, 14–17]. However surprisingly, Alam et al reported in a systematic review of the literature occurrence of postprocedural ventricular fibrillation 2.2%[2].…”

A Decade of Percutaneous Septal Ablation in Hypertrophic Cardiomyopathy

“…Ventricular arrhythmias have been reported in the early postprocedural phase, possibly as an effect of ischemia. 67,83- 85 With the exception of 1 study, 86 long-term follow-up data have described ventricular arrhythmias as a rare event. 32- 35 In contrast, no increased risk of malignant arrhythmias after the procedure has been shown in patients who already had an ICD implanted because of a previously estimated high risk of sudden death.…”