Browsing by Author "Bakken Wold, Ane"

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    The effects of treatment with alcohol septal ablation in patients with Hypertrophic obstructive cardiomyopathy
    (2022-05-23) Bakken Wold, Ane; University of Gothenburg / Institute of Medicine; Göteborgs universitet / Institutionen för medicin
    Background: Hypertrophic Cardiomyopathy is the most common of the inherited cardiomyopathies. When the hypertrophic myocardium affects the interventricular septum, it can cause left ventricular outflow tract obstruction (LVOTO), resulting in Hypertrophic obstructive cardiomyopathy (HOCM). Patients are treated with negative ionotropic drugs in order to relieve symptoms. Patients who still have symptoms while on appropriate medical therapy are candidates for septal reduction therapy. Septal reduction therapy includes myectomy and the newer and less invasive alternative of alcohol septal ablation (ASA). Aim: To describe the group of patients who have been treated with ASA at Sahlgrenska University Hospital and assess the effectiveness of treatment. Methods: In this study, we used an observational cohort design. The cohort included 68 patients with HOCM who received treatment with ASA. Data was collected from preexisting medical records. Results: There was a reduction in New York Heart Association (NYHA) functional class from a mean of 2.8 at baseline to 2.1 at the time of follow-up (p<0.001). A decrease in LVOTO from a median of 81 mmHg to 20 mmHg was documented after treatment with ASA (p<0.001). The dosing of beta-blockers was reduced from a median of 175 mg/day at baseline to 150 mg/day at the time of follow-up examination (p=0.016). At baseline, 22.4% of patients had the anti-arrhythmic drug Disopyramide. This number was reduced to 11.5% at the time of follow-up (p=0.021). Time to follow-up after intervention had a mean of 6.3 months. Conclusion: ASA is an effective form of septal reduction therapy for selected patients with HOCM. Reduction of LVOTO led to symptomatic improvement for most of the patients. In addition, the observed reduction in use and dose of beta-blockade and Disopyramide after treatment with ASA further supports the effectiveness of treatment.