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Safety and efficacy of alcohol septal ablation in adolescents and young adults with hypertrophic obstructive cardiomyopathy

Abstract

Introduction

Data regarding alcohol septal ablation (ASA) in young patients with hypertrophic obstructive cardiomyopathy (HOCM) are scarce. The purpose of our study is to evaluate the safety and efficacy of ASA in patients ≤ 25 years.

Methods and results

All ASAs between 2002 and 2020 at our institution were assigned to a group of patients 14–25 years of age (group 1) and a reference group > 25 years (group 2). 1,264 procedures were analysed in group 2 (58.6 ± 13.5 years) and 41 procedures in group 1 (20.9 ± 3.3 years). The baseline interventricular septal diameter (IVSD) was higher in group 1 (26.0 ± 6.5 mm vs. 21.3 ± 4.4 mm; p < 0.0001). There was no difference in baseline left ventricular outflow tract gradient (LVOTG) (group 1: 54.4 ± 24.4 mmHg; group 2: 52.4 ± 36.6 mmHg; p = n.s.). A previous cardiac device was more often observed in group 1 (31.7% vs. 9.0%; p < 0.0001). Symptoms were improved after 6 months (group 1: mean NYHA class 2.5 at baseline and 1.3 at FU; p < 0.0001; group 2: mean NYHA class 2.7 at baseline and 1.4 at FU; p <0 .0001). IVSD (group 1: 20.3 ± 8.2 mm; group 2: 16.8 ± 5.7 mm; p < 0.0001 for each group compared to baseline) and LVOTG improved during FU (group 1: 25.5 ± 20.0 mmHg; group 2: 22.1 ± 21.7 mmHg; p < 0.0001 for each group). Intrahospital mortality was 0.0% in patients 14–25 years and 0.9% in the reference group. Persistent AV-block was observed in 12.2% of the group 1 and 15.9% of the group 2 patients (p = n.s.).

Conclusion

ASA is safe and effective in HOCM patients 14–25 years of age in experienced centres.

Graphical abstract

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Availability of data and material

The original data are to the authors.

Code availability

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Correspondence to Christoph Stellbrink.

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Ethics approval

The research project was approved by the ethics committee of the Westfälische Wilhelms-University Münster, Germany (file number 2020-780-f-S).

Consent to participate

Referring to the national ethical guidelines of Germany (§6 Gesundheitsdatenschutzgesetz NRW), the authors waived consent to participate due to retrospective study design and only intra-departmental data collection in our analysis. This was approved by the ethics committee of the Westfälische Wilhelms-University Münster, Germany (file number 2020-780-f-S).

Consent for publication

Referring to the national ethical guidelines of Germany (§6 Gesundheitsdatenschutzgesetz NRW), the authors waived consent to publication due to retrospective study design and only intra-departmental data collection in our analysis. This was approved by the ethics committee of the Westfälische Wilhelms-University Münster, Germany (file number 2020-780-f-S).

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Cite this article

Lawin, D., Lawrenz, T., Radke, K. et al. Safety and efficacy of alcohol septal ablation in adolescents and young adults with hypertrophic obstructive cardiomyopathy. Clin Res Cardiol (2021). https://doi.org/10.1007/s00392-021-01960-6

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Keywords

  • Adolescents
  • Alcohol septal ablation
  • Hypertrophic obstructive cardiomyopathy
  • Outcome
  • Young adults