Author + information
- Lothar Faber,
- Christian Prinz,
- Martina Schumann,
- Amelie Burghardt,
- Hubert Seggewiss and
- Dieter Horstkotte
Background and Methods
We analyzed the long-term outcome in 552 consecutive patients (pts., mean age: 56±14 years) treated with percutaneous septal ablation (PTSMA) for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Data were acquired by outpatient examination in our own institution or by phone contact with the pts.’ local cardiologist. Pts. who could not be traced neither personally nor via their local physician or their health insurance company were considered “lost” to follow-up.
In-hospital mortality was 1% (5 pts.). Mean CK rise was 512±251 U/l (reference: <80). A DDD-pacemaker (DDD-PM) had to be implanted in 43 pts. (8%) for procedure-related AV conduction problems. Follow-up was 98% complete (n=542). During follow-up (65±51 [range: 0.4-184] months), 55 pts. (10%) died, of these 28 (5%) from non-cardiac, and 27 (5%) from cardiovascular causes. Overall survival was 93% at 5 years, and 90% at 10 years. A re-intervention for significant residual or recurrent outflow obstruction was needed in 49 pts. (9%; re-PTSMA: 22 pts.; myectomy: 27 pts.). These cases included, at their last follow-up visit 477 pts. (88%) were in functional class I or II. There were additional 9 DDD-PM implantations (2%) and 15 (3%) ICD implantations (3 for secondary, 12 for primary prevention of sudden cardiac death). The most frequent problem was atrial fibrillation in 62 pts. (11%), refractory to rhythm control attempts in 47 pts. (8%).
During long-term follow up following PTSMA, a persistent clinical improvement was observed. A second intervention (surgical or catheter-based) was needed in about 10%. The 10-year survival rate observed in this cohort compares favourably with the natural disease course in symptomatic HOCM, and seems to be equivalent to post-myectomy data.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Hypertrophic Cardiomyopathy: Variants and Outcomes
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 1122-150
- 2013 American College of Cardiology Foundation