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首页> 外文期刊>The American Journal of Cardiology >Ventricular arrhythmia following alcohol septal ablation for obstructive hypertrophic cardiomyopathy.
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Ventricular arrhythmia following alcohol septal ablation for obstructive hypertrophic cardiomyopathy.

机译：酒精中隔消融后室性心律失常用于梗阻性肥厚型心肌病。

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摘要

We sought to assess the risk of sudden cardiac death (SCD) and ventricular arrhythmia after alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy. ASA is a nonsurgical alternative to septal myectomy for treatment of symptomatic, drug-refractory, obstructive hypertrophic cardiomyopathy. The effect of ASA on ventricular arrhythmia risk is not well established. We examined the rates of SCD among 89 patients treated with ASA. The secondary end point was ventricular tachycardia/ventricular fibrillation (VT/VF), appropriate implantable cardioverter defibrillator (ICD) therapy, or cardiac arrest after ASA among those with implanted ICDs or permanent pacemakers (n = 42). Patients were classified as either high-risk or low-risk on the basis of established clinical indications for ICD implantation. No mortality was attributable to SCD at a mean follow-up of 5.0 +/- 2.3 years in the entire cohort. Among the 42 patients with an ICD or permanent pacemaker, 9 had documented VT/VF, cardiac arrest, or appropriate ICD therapy, resulting in an annual event rate of 4.9%/year. The annual event rate for VT/VF, cardiac arrest, or appropriate ICD therapy was 2.8%/year (4 of 29 patients) in low-risk patients and 13.4% in high-risk patients (5 of 13 patients). A 10-mm Hg increase in the immediate post-ASA gradient was associated with a hazard ratio of 2.66 for arrhythmic events (95% confidence interval 1.55 to 4.56, p <0.001). In conclusion, ASA was performed in patients with highly symptomatic, drug-refractory hypertrophic cardiomyopathy with no mortality attributable to SCD and an annual rate of VT/VF, cardiac arrest, or appropriate ICD therapy of 4.9%/year.
机译：我们试图评估梗阻性肥厚型心肌病的酒精中隔消融（ASA）后发生心源性猝死（SCD）和室性心律失常的风险。 ASA是隔肌切除术的非手术替代疗法，用于治疗症状性，药物难治性，梗阻性肥厚型心肌病。 ASA对室性心律失常风险的影响尚不明确。我们检查了89例接受ASA治疗的患者中SCD的发生率。次要终点是植入ICD或永久起搏器的患者中，室性心动过速/心室纤颤（VT / VF），适当的植入式心脏复律除颤器（ICD）治疗或ASA后心脏骤停（n = 42）。根据确定的ICD植入临床指征，将患者分为高危或低危。在整个队列中，平均随访时间为5.0 +/- 2.3年，无因SCD引起的死亡率。在42名患有ICD或永久性起搏器的患者中，有9名记录了VT / VF，心脏骤停或适当的ICD治疗，导致每年事件发生率为4.9％/年。低危患者的VT / VF，心脏骤停或适当的ICD治疗的年事件发生率为2.8％/年（29名患者中的4名），高危患者（13名患者中的5名）的13.4％/年。 ASA后立即梯度增加10 mm Hg与心律失常事件的危险比2.66相关（95％置信区间1.55至4.56，p <0.001）。总而言之，ASA是在症状严重，药物难治性肥厚性心肌病，无SCD死亡率，每年VT / VF，心脏骤停或4.9％/年的适当ICD治疗率的患者中进行的。

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