Effect of Institutional Experience on Outcomes of Alcohol
Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

J 2018

Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

VESELKA, Josef, Lothar FABER, Morten Kvistholm JENSEN, Robert COOPER, Jaroslav JANUSKA et. al.

Basic information

Original name

Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Authors

VESELKA, Josef (203 Czech Republic, guarantor), Lothar FABER (276 Germany), Morten Kvistholm JENSEN (208 Denmark), Robert COOPER (826 United Kingdom of Great Britain and Northern Ireland), Jaroslav JANUSKA (203 Czech Republic), Jan KREJČÍ (203 Czech Republic, belonging to the institution), Thomas BARTEL (784 United Arab Emirates), Maciej DABROWSKI (616 Poland), Peter Riis HANSEN (208 Denmark), Vibeke Marie ALMAAS (578 Norway), Hubert SEGGEWISS (276 Germany), Dieter HORSTKOTTE (276 Germany), Radka ADLOVA (203 Czech Republic), Henning BUNDGAARD (208 Denmark), Jurrien ten BERG (528 Netherlands) and Max LIEBREGTS (528 Netherlands)

Edition

Canadian Journal of Cardiology, New York, Elsevier Science Ltd. 2018, 0828-282X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 5.592

RIV identification code

RIV/00216224:14110/18:00105231

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.cjca.2017.10.020

UT WoS

000418674300007

Keywords in English

hypertrophic cardiomyopathy

Abstract

V originále

Background: The current American College of Cardiology Foundation/American Heart Association guidelines on hypertrophic cardiomyopathy state that institutional experience is a key determinant of successful outcomes and lower complication rates of alcohol septal ablation (ASA). The aim of this study was to evaluate the safety and efficacy of ASA according to institutional experience with the procedure. Methods: We retrospectively evaluated 1310 patients with symptomatic obstructive hypertrophic cardiomyopathy who underwent ASA and were divided into 2 groups. The first-50 group consisted of the first consecutive 50 patients treated at each centre, and the over-50 group consisted of patients treated thereafter (patients 51 and above). Results: In the 30-day follow-up, there was a significant difference in the occurrence of major cardiovascular adverse events (21% in the first-50 group vs 12% in the over-50 group; P < 0.01), which was driven by the occurrence of cardiovascular deaths (2.1% vs 0.4%; P = 0.01) and implanted pacemakers (15% vs 9%; P < 0.01). In the long-term follow-up (5.5 +/- 4.1 years), the first-50 group was associated with a significantly higher occurrence of major adverse events (P < 0.01) and higher cardiovascular mortality (P < 0.01). Also, patients in the first-50 group were more likely to self-report dyspnea of New York Heart Association class III/IV (16% vs 10%), to have a left ventricular outflow gradient > 30 mm Hg (16% vs 10%) at the last clinical check-up (P < 0.01 for both), and a probability of repeated septal reduction therapy (P = 0.03). Conclusions: An institutional experience of > 50 ASA procedures was associated with a lower occurrence of ASA complications, better cardiovascular survival, better hemodynamic and clinical effect, and less need for repeated septal reduction therapy.

Citovat

VESELKA, Josef, Lothar FABER, Morten Kvistholm JENSEN, Robert COOPER, Jaroslav JANUSKA, Jan KREJČÍ, Thomas BARTEL, Maciej DABROWSKI, Peter Riis HANSEN, Vibeke Marie ALMAAS, Hubert SEGGEWISS, Dieter HORSTKOTTE, Radka ADLOVA, Henning BUNDGAARD, Jurrien ten BERG and Max LIEBREGTS. Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy. Canadian Journal of Cardiology. New York: Elsevier Science Ltd., 2018, vol. 34, No 1, p. 16-22. ISSN 0828-282X. Available from: https://dx.doi.org/10.1016/j.cjca.2017.10.020.

@article{1483018,
   author = {Veselka, Josef and Faber, Lothar and Jensen, Morten Kvistholm and Cooper, Robert and Januska, Jaroslav and Krejčí, Jan and Bartel, Thomas and Dabrowski, Maciej and Hansen, Peter Riis and Almaas, Vibeke Marie and Seggewiss, Hubert and Horstkotte, Dieter and Adlova, Radka and Bundgaard, Henning and Berg, Jurrien ten and Liebregts, Max},
   article_location = {New York},
   article_number = {1},
   doi = {http://dx.doi.org/10.1016/j.cjca.2017.10.020},
   keywords = {hypertrophic cardiomyopathy},
   language = {eng},
   issn = {0828-282X},
   journal = {Canadian Journal of Cardiology},
   title = {Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy},
   volume = {34},
   year = {2018}
}

TY  - JOUR
ID  - 1483018
AU  - Veselka, Josef - Faber, Lothar - Jensen, Morten Kvistholm - Cooper, Robert - Januska, Jaroslav - Krejčí, Jan - Bartel, Thomas - Dabrowski, Maciej - Hansen, Peter Riis - Almaas, Vibeke Marie - Seggewiss, Hubert - Horstkotte, Dieter - Adlova, Radka - Bundgaard, Henning - Berg, Jurrien ten - Liebregts, Max
PY  - 2018
TI  - Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy
JF  - Canadian Journal of Cardiology
VL  - 34
IS  - 1
SP  - 16-22
EP  - 16-22
PB  - Elsevier Science Ltd.
SN  - 0828282X
KW  - hypertrophic cardiomyopathy
N2  - Background: The current American College of Cardiology Foundation/American Heart Association guidelines on hypertrophic cardiomyopathy state that institutional experience is a key determinant of successful outcomes and lower complication rates of alcohol septal ablation (ASA). The aim of this study was to evaluate the safety and efficacy of ASA according to institutional experience with the procedure. Methods: We retrospectively evaluated 1310 patients with symptomatic obstructive hypertrophic cardiomyopathy who underwent ASA and were divided into 2 groups. The first-50 group consisted of the first consecutive 50 patients treated at each centre, and the over-50 group consisted of patients treated thereafter (patients 51 and above). Results: In the 30-day follow-up, there was a significant difference in the occurrence of major cardiovascular adverse events (21% in the first-50 group vs 12% in the over-50 group; P < 0.01), which was driven by the occurrence of cardiovascular deaths (2.1% vs 0.4%; P = 0.01) and implanted pacemakers (15% vs 9%; P < 0.01). In the long-term follow-up (5.5 +/- 4.1 years), the first-50 group was associated with a significantly higher occurrence of major adverse events (P < 0.01) and higher cardiovascular mortality (P < 0.01). Also, patients in the first-50 group were more likely to self-report dyspnea of New York Heart Association class III/IV (16% vs 10%), to have a left ventricular outflow gradient > 30 mm Hg (16% vs 10%) at the last clinical check-up (P < 0.01 for both), and a probability of repeated septal reduction therapy (P = 0.03). Conclusions: An institutional experience of > 50 ASA procedures was associated with a lower occurrence of ASA complications, better cardiovascular survival, better hemodynamic and clinical effect, and less need for repeated septal reduction therapy.
ER  -

VESELKA, Josef, Lothar FABER, Morten Kvistholm JENSEN, Robert COOPER, Jaroslav JANUSKA, Jan KREJČÍ, Thomas BARTEL, Maciej DABROWSKI, Peter Riis HANSEN, Vibeke Marie ALMAAS, Hubert SEGGEWISS, Dieter HORSTKOTTE, Radka ADLOVA, Henning BUNDGAARD, Jurrien ten BERG and Max LIEBREGTS. Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy. \textit{Canadian Journal of Cardiology}. New York: Elsevier Science Ltd., 2018, vol.~34, No~1, p.~16-22. ISSN~0828-282X. Available from: https://dx.doi.org/10.1016/j.cjca.2017.10.020.

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