How treatments for obstruction in hypertrophic cardiomyopathy compare

30th November 2015

A new study has compared alternative treatments for treating obstruction in hypertrophic cardiomyopathy.

In some patients with the disease, thickening of the heart muscle can obstruct blood flow out of the heart. This can increase a range of symptoms and may need treating.

Often drugs treatments are sufficient, but sometimes more invasive procedures are considered. This is usually septal alcohol ablation or myectomy.

In a myectomy, a section of the thickened muscle causing the obstruction is removed during open heart surgery.

Septal alcohol ablation is a less invasive procedure in which pure alcohol is injected into the heart via a vein in the leg. It is designed to destroys heart cells in the affected area, causing them to die and the obstruction to reduce. It is often thought to be the best choice for older patients.

Now a small study in Holland of how patients do in the years after having the rival procedures has concluded that the long term risks of dying or surviving a cardiac arrest after either procedure are similarly low, but patients who have the septal ablation are twice as likely to need a permanent pacemaker and five times more likely to need additional septal reduction therapy compared to those who have a myectomy.

The study, led by Dr Max Liebregts from St Antonius Hospital, Nieuwegein, included sixteen patients who had had a myectomy and 11 who had had a septal alcohol ablation. They were followed up for a mean of 7.4 and 6.2 years respectively, with all having had the procedure at least three years before.

The study was published in the Journal of the American College of Cardiology.