Permanent pacemaker implantation after alcoholic septal ablation induced complete heart block : Long-term impact
Copyright © 2023. Publicado por Elsevier España, S.L.U..
INTRODUCTION AND OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy (HOCM) that remain symptomatic despite optimized medical therapy often undergo alcohol septal ablation (ASA). One of the most frequent complications is complete heart block (CHB), requiring a permanent pacemaker (PPM) in variable rates of up to 20% of patients. The long-term impact of PPM implantation in these patients remains unclear. This study aimed to evaluate the long-term clinical outcomes in patients who implant PPM after ASA.
METHODS: Patients who underwent ASA at a tertiary center were consecutively and prospectively enrolled. Patients with previous PPM or implantable cardio-defibrillator were excluded from this analysis. Patients with and without PPM implantation after ASA were compared based on their baseline characteristics, procedure data and three-year primary endpoint of composite of all-cause mortality and hospitalization and secondary endpoint of composite of all-cause mortality and cardiac cause hospitalization.
RESULTS: Between 2009 and 2019, 109 patients underwent ASA, 97 of whom were included in this analysis (68% female, mean age 65.2 years old). 16 patients (16.5%) required PPM implantation for CHB. In these patients, no vascular access, pacemaker pocket or pulmonary parenchyma complications were noted. The baseline characteristics of comorbidities, symptoms, echocardiographic and electrocardiographic findings were identical in the two groups, with higher mean age (70.6±10.0 years vs. 64.1±11.9 years) and lower beta-blocker therapy rate (56% vs. 84%) in the PPM group. Procedure-related data showed higher creatine kinase (CK) peaks in the PPM group (1692 U/L vs. 1243 U/L), with no significant difference in the alcohol dose. At three years after ASA procedure, there were no differences in the primary and secondary endpoints between the two groups.
CONCLUSIONS: Permanent pacemaker after ASA induced CHB do not affect long term prognosis in hypertrophic obstructive cardiomyopathy patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 2023 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
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| Enthalten in: |
Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology - 43(2023), 1 vom: 25. Jan., Seite 13-19 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Grazina, André [VerfasserIn] |
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| Links: |
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| Themen: |
Ablação septal alcoólica |
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| Anmerkungen: |
Date Completed 26.12.2023 Date Revised 26.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.repc.2023.04.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359243592 |
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| 245 | 1 | 0 | |a Permanent pacemaker implantation after alcoholic septal ablation induced complete heart block |b Long-term impact |
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| 500 | |a Date Revised 26.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Publicado por Elsevier España, S.L.U. | ||
| 520 | |a INTRODUCTION AND OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy (HOCM) that remain symptomatic despite optimized medical therapy often undergo alcohol septal ablation (ASA). One of the most frequent complications is complete heart block (CHB), requiring a permanent pacemaker (PPM) in variable rates of up to 20% of patients. The long-term impact of PPM implantation in these patients remains unclear. This study aimed to evaluate the long-term clinical outcomes in patients who implant PPM after ASA | ||
| 520 | |a METHODS: Patients who underwent ASA at a tertiary center were consecutively and prospectively enrolled. Patients with previous PPM or implantable cardio-defibrillator were excluded from this analysis. Patients with and without PPM implantation after ASA were compared based on their baseline characteristics, procedure data and three-year primary endpoint of composite of all-cause mortality and hospitalization and secondary endpoint of composite of all-cause mortality and cardiac cause hospitalization | ||
| 520 | |a RESULTS: Between 2009 and 2019, 109 patients underwent ASA, 97 of whom were included in this analysis (68% female, mean age 65.2 years old). 16 patients (16.5%) required PPM implantation for CHB. In these patients, no vascular access, pacemaker pocket or pulmonary parenchyma complications were noted. The baseline characteristics of comorbidities, symptoms, echocardiographic and electrocardiographic findings were identical in the two groups, with higher mean age (70.6±10.0 years vs. 64.1±11.9 years) and lower beta-blocker therapy rate (56% vs. 84%) in the PPM group. Procedure-related data showed higher creatine kinase (CK) peaks in the PPM group (1692 U/L vs. 1243 U/L), with no significant difference in the alcohol dose. At three years after ASA procedure, there were no differences in the primary and secondary endpoints between the two groups | ||
| 520 | |a CONCLUSIONS: Permanent pacemaker after ASA induced CHB do not affect long term prognosis in hypertrophic obstructive cardiomyopathy patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Ablação septal alcoólica | |
| 650 | 4 | |a Alcoholic septal ablation | |
| 650 | 4 | |a Miocardiopatia hipertrófica obstrutiva | |
| 650 | 4 | |a Obstructive hypertrophic cardiomyopathy | |
| 650 | 4 | |a Pacemaker | |
| 700 | 1 | |a Cardoso, Isabel |e verfasserin |4 aut | |
| 700 | 1 | |a Fiarresga, António |e verfasserin |4 aut | |
| 700 | 1 | |a Aguiar Rosa, Sílvia |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia Brás, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, Vera |e verfasserin |4 aut | |
| 700 | 1 | |a Viegas, José Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Lacerda Teixeira, Bárbara |e verfasserin |4 aut | |
| 700 | 1 | |a Ramos, Rúben |e verfasserin |4 aut | |
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| 700 | 1 | |a Cacela, Duarte |e verfasserin |4 aut | |
| 700 | 1 | |a Cruz Ferreira, Rui |e verfasserin |4 aut | |
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