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The aim of this study is to identify the differences in incidence of (aborted) sudden cardiac death (SCD) in patients with hypertrophic obstructive cardiomyopathy (HOCM) who received medical treatment, alcohol septal ablation (ASA) or myectomy.
In a cohort of 527 hypertrophic cardiomyopathy patients 277 (53%) patients (age 56, 62% male) with left ventricular outflow tract gradient >30mmHg were included in this observational study. Follow-up was successful in 99% of the patients. Kaplan-Meier graphs and Cox regression models were used for statistical analyses and variables are expressed as Hazard ratio (HR) with 95% confidence interval.
During a median follow-up of 7.0 years the rate of life-threatening arrhythmias, including (aborted) SCD and appropriate ICD therapy, was significantly higher in patients after ASA compared to patients who had medical or surgical treatment (Figure 1). Cardiac death occurred in 38 patients (1.0%/year). (Aborted) SCD occurred in 33 patients (1.0%/year) and was associated with ASA (HR 2.4 [1.2-5.5], p=0.012) and left ventricular wall thickness > 20 mm (HR 2.1 [1.1-4.0], p=0.029). Seventy patients (13%) received an ICD during follow-up, 22 (24%) in the ASA group.
SCD in medically treated patients with HOCM is low. Patients with HOCM who underwent surgical myectomy have a similar long-term outcome as medically treated patients. Patients with HOCM who underwent ASA are at increased risk of SCD.
West, Room 3002
Sunday, March 10, 2013, Noon-12:15 p.m.
Session Title: Hypertrophic Cardiomyopathy
Abstract Category: 23. Pericardial/Myocardial Disease
Presentation Number: 927-8
- 2013 American College of Cardiology Foundation