Alcohol septal ablation for hypertrophic cardiomyopathy: Indications and technique

David Holmes, Uma S. Valeti, Rick A. Nishimura

Research output: Contribution to journalReview article

55 Citations (Scopus)

Abstract

Alcohol septal ablation for the treatment of hypertrophic cardiomyopathy has been the subject of great interest, and the number of procedures performed is increasing despite an absence of randomized trial data. Although straightforward in concept, alcohol septal ablation may be considerably more difficult in actual practice. To optimize the results and prevent complications, the anatomy of the septal arcade architecture must be understood and the anatomic relationship between the septal artery and the specific portion of the septum to be ablated must be carefully delineated. For the latter, during the procedure, an echocardiographic contrast medium injection into the septal artery of interest is essential. Selection of the volume and amount of alcohol to be injected varies depending on the size and distribution of the septal artery. Specific complications such as conduction defects, hemodynamic compromise, ventricular arrhythmias, and inadequate gradient reduction can be minimized by specific technical approaches. After ablation, protocols are needed for periprocedural guidelines because some complications may occur late during the next several days. For optimal results, patients need to be selected after catheter assessment and combined echocardiography and angiography, and ablation techniques need to be scientific and rigorous.

Original languageEnglish (US)
Pages (from-to)375-389
Number of pages15
JournalCatheterization and Cardiovascular Interventions
Volume66
Issue number3
DOIs
StatePublished - Nov 1 2005

Fingerprint

Hypertrophic Cardiomyopathy
Arteries
Alcohols
Ablation Techniques
Contrast Media
Echocardiography
Cardiac Arrhythmias
Anatomy
Angiography
Catheters
Hemodynamics
Guidelines
Injections
Therapeutics

Keywords

  • Heart septum
  • Left ventricular outflow obstruction
  • Myocardial disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Alcohol septal ablation for hypertrophic cardiomyopathy : Indications and technique. / Holmes, David; Valeti, Uma S.; Nishimura, Rick A.

In: Catheterization and Cardiovascular Interventions, Vol. 66, No. 3, 01.11.2005, p. 375-389.

Research output: Contribution to journalReview article

@article{0d1a5d15301e4ed4b56aee3abaa6453b,
title = "Alcohol septal ablation for hypertrophic cardiomyopathy: Indications and technique",
abstract = "Alcohol septal ablation for the treatment of hypertrophic cardiomyopathy has been the subject of great interest, and the number of procedures performed is increasing despite an absence of randomized trial data. Although straightforward in concept, alcohol septal ablation may be considerably more difficult in actual practice. To optimize the results and prevent complications, the anatomy of the septal arcade architecture must be understood and the anatomic relationship between the septal artery and the specific portion of the septum to be ablated must be carefully delineated. For the latter, during the procedure, an echocardiographic contrast medium injection into the septal artery of interest is essential. Selection of the volume and amount of alcohol to be injected varies depending on the size and distribution of the septal artery. Specific complications such as conduction defects, hemodynamic compromise, ventricular arrhythmias, and inadequate gradient reduction can be minimized by specific technical approaches. After ablation, protocols are needed for periprocedural guidelines because some complications may occur late during the next several days. For optimal results, patients need to be selected after catheter assessment and combined echocardiography and angiography, and ablation techniques need to be scientific and rigorous.",
keywords = "Heart septum, Left ventricular outflow obstruction, Myocardial disease",
author = "David Holmes and Valeti, {Uma S.} and Nishimura, {Rick A.}",
year = "2005",
month = "11",
day = "1",
doi = "10.1002/ccd.20500",
language = "English (US)",
volume = "66",
pages = "375--389",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Alcohol septal ablation for hypertrophic cardiomyopathy

T2 - Indications and technique

AU - Holmes, David

AU - Valeti, Uma S.

AU - Nishimura, Rick A.

PY - 2005/11/1

Y1 - 2005/11/1

N2 - Alcohol septal ablation for the treatment of hypertrophic cardiomyopathy has been the subject of great interest, and the number of procedures performed is increasing despite an absence of randomized trial data. Although straightforward in concept, alcohol septal ablation may be considerably more difficult in actual practice. To optimize the results and prevent complications, the anatomy of the septal arcade architecture must be understood and the anatomic relationship between the septal artery and the specific portion of the septum to be ablated must be carefully delineated. For the latter, during the procedure, an echocardiographic contrast medium injection into the septal artery of interest is essential. Selection of the volume and amount of alcohol to be injected varies depending on the size and distribution of the septal artery. Specific complications such as conduction defects, hemodynamic compromise, ventricular arrhythmias, and inadequate gradient reduction can be minimized by specific technical approaches. After ablation, protocols are needed for periprocedural guidelines because some complications may occur late during the next several days. For optimal results, patients need to be selected after catheter assessment and combined echocardiography and angiography, and ablation techniques need to be scientific and rigorous.

AB - Alcohol septal ablation for the treatment of hypertrophic cardiomyopathy has been the subject of great interest, and the number of procedures performed is increasing despite an absence of randomized trial data. Although straightforward in concept, alcohol septal ablation may be considerably more difficult in actual practice. To optimize the results and prevent complications, the anatomy of the septal arcade architecture must be understood and the anatomic relationship between the septal artery and the specific portion of the septum to be ablated must be carefully delineated. For the latter, during the procedure, an echocardiographic contrast medium injection into the septal artery of interest is essential. Selection of the volume and amount of alcohol to be injected varies depending on the size and distribution of the septal artery. Specific complications such as conduction defects, hemodynamic compromise, ventricular arrhythmias, and inadequate gradient reduction can be minimized by specific technical approaches. After ablation, protocols are needed for periprocedural guidelines because some complications may occur late during the next several days. For optimal results, patients need to be selected after catheter assessment and combined echocardiography and angiography, and ablation techniques need to be scientific and rigorous.

KW - Heart septum

KW - Left ventricular outflow obstruction

KW - Myocardial disease

UR - http://www.scopus.com/inward/record.url?scp=27644505168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=27644505168&partnerID=8YFLogxK

U2 - 10.1002/ccd.20500

DO - 10.1002/ccd.20500

M3 - Review article

C2 - 16216025

AN - SCOPUS:27644505168

VL - 66

SP - 375

EP - 389

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 3

ER -