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@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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