Effect of impaired cardiac conduction after alcohol septal ablation on clinical outcomes: insights from the Euro-ASA registry
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Effect of impaired cardiac conduction after alcohol septal ablation on clinical outcomes : insights from the Euro-ASA registry. / Jensen, Morten Kvistholm; Faber, Lothar; Liebregts, Max; Januska, Jaroslav; Krejci, Jan; Bartel, Thomas; Cooper, Robert M; Dabrowski, Maciej; Hansen, Peter Riis; Almaas, Vibeke Marie; Seggewiss, Hubert; Horstkotte, Dieter; Adlova, Radka; Berg, Jurriën Ten; Bundgaard, Henning; Veselka, Josef.
In: European Heart Journal - Quality of Care and Clinical Outcomes, Vol. 5, No. 3, 01.07.2019, p. 252-258.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effect of impaired cardiac conduction after alcohol septal ablation on clinical outcomes
T2 - insights from the Euro-ASA registry
AU - Jensen, Morten Kvistholm
AU - Faber, Lothar
AU - Liebregts, Max
AU - Januska, Jaroslav
AU - Krejci, Jan
AU - Bartel, Thomas
AU - Cooper, Robert M
AU - Dabrowski, Maciej
AU - Hansen, Peter Riis
AU - Almaas, Vibeke Marie
AU - Seggewiss, Hubert
AU - Horstkotte, Dieter
AU - Adlova, Radka
AU - Berg, Jurriën Ten
AU - Bundgaard, Henning
AU - Veselka, Josef
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - AIMS: We analysed the impact of bundle branch block (BBB) and pacemaker (PM) implantation on symptoms and survival after alcohol septal ablation (ASA) in patients with hypertrophic cardiomyopathy (HCM).METHODS AND RESULTS: Among 1416 HCM patients from the Euro-ASA registry, 58 (4%) patients had a PM and 64 (5%) patients had an implantable cardioverter-defibrillator (ICD) before ASA. At latest follow-up (5.0 ± 4.0 years) after ASA, 118 (8%) patients had an ICD and 229 (16%) patients had a PM. In patients without an implantable device prior to ASA 13% had a PM and 5% had an ICD implanted following ASA. New onset BBB was present in 44% (right BBB in 31%) of patients without previous BBB. At latest follow-up, we found no associations between BBB and New York Heart Association (NYHA) Class 3-4 [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.63-1.51; P = 0.91] or Canadian Cardiovascular Society (CCS) Class 3-4 (OR 1.5, CI 0.32-6.7; P = 0.62), respectively, and no associations between PM and NYHA Class 3-4 (OR 1.2, CI 0.70-2.0; P = 0.52) or CCS 3-4 (OR 1.3, CI 0.24-6.6; P = 0.79), respectively. The survival after ASA was not reduced in patients with BBB [hazard ratio (HR) 0.73, CI 0.53-1.01; P = 0.06] or PM (HR 0.78, CI 0.52-1.17; P = 0.24).CONCLUSIONS: Development of BBB or need for a PM after ASA in patients with obstructive HCM was not associated with inferior symptomatic outcome or reduced survival, thus concerns for the negative impact of impaired cardiac conduction on the clinical outcome after ASA were not confirmed.
AB - AIMS: We analysed the impact of bundle branch block (BBB) and pacemaker (PM) implantation on symptoms and survival after alcohol septal ablation (ASA) in patients with hypertrophic cardiomyopathy (HCM).METHODS AND RESULTS: Among 1416 HCM patients from the Euro-ASA registry, 58 (4%) patients had a PM and 64 (5%) patients had an implantable cardioverter-defibrillator (ICD) before ASA. At latest follow-up (5.0 ± 4.0 years) after ASA, 118 (8%) patients had an ICD and 229 (16%) patients had a PM. In patients without an implantable device prior to ASA 13% had a PM and 5% had an ICD implanted following ASA. New onset BBB was present in 44% (right BBB in 31%) of patients without previous BBB. At latest follow-up, we found no associations between BBB and New York Heart Association (NYHA) Class 3-4 [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.63-1.51; P = 0.91] or Canadian Cardiovascular Society (CCS) Class 3-4 (OR 1.5, CI 0.32-6.7; P = 0.62), respectively, and no associations between PM and NYHA Class 3-4 (OR 1.2, CI 0.70-2.0; P = 0.52) or CCS 3-4 (OR 1.3, CI 0.24-6.6; P = 0.79), respectively. The survival after ASA was not reduced in patients with BBB [hazard ratio (HR) 0.73, CI 0.53-1.01; P = 0.06] or PM (HR 0.78, CI 0.52-1.17; P = 0.24).CONCLUSIONS: Development of BBB or need for a PM after ASA in patients with obstructive HCM was not associated with inferior symptomatic outcome or reduced survival, thus concerns for the negative impact of impaired cardiac conduction on the clinical outcome after ASA were not confirmed.
U2 - 10.1093/ehjqcco/qcy049
DO - 10.1093/ehjqcco/qcy049
M3 - Journal article
C2 - 30304395
VL - 5
SP - 252
EP - 258
JO - European Heart Journal - Quality of Care and Clinical Outcomes
JF - European Heart Journal - Quality of Care and Clinical Outcomes
SN - 2058-5225
IS - 3
ER -
ID: 234147704