Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy
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Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. / Axelsson, Anna; Weibring, Kristina; Havndrup, Ole; Kelbæk, Henning; Jørgensen, Erik; Helqvist, Steffen; Iversen, Kasper; Køber, Lars; Bundgaard, Henning; Jensen, Morten Kvistholm.
I: Journal of Cardiovascular Medicine (Hagerstown), Bind 15, Nr. 3, 03.2014, s. 214-221.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Atrioventricular conduction after alcohol septal ablation for obstructive hypertrophic cardiomyopathy
AU - Axelsson, Anna
AU - Weibring, Kristina
AU - Havndrup, Ole
AU - Kelbæk, Henning
AU - Jørgensen, Erik
AU - Helqvist, Steffen
AU - Iversen, Kasper
AU - Køber, Lars
AU - Bundgaard, Henning
AU - Jensen, Morten Kvistholm
PY - 2014/3
Y1 - 2014/3
N2 - AIMS: Lesion of the atrioventricular conduction system is a well known adverse effect of alcohol septal ablation (ASA) in patients with obstructive hypertrophic cardiomyopathy (HCM). We assessed the atrioventricular conduction at long-term follow-up after ASA.METHODS: In patients with a pacemaker implanted for high-grade atrioventricular block after ASA, the atrioventricular conduction was assessed prospectively by ECGs and 48-h Holter recordings. In the remaining patients, the atrioventricular conduction was analysed retrospectively for comparison.RESULTS: A total of 24 (28%) of 87 patients with obstructive HCM without a pacemaker at baseline had a pacemaker implanted due to high-grade atrioventricular block after ASA. Ten of these patients were not available for follow-up. Holter recordings in the remaining 14 patients revealed normalized atrioventricular conduction in 6 patients 6.2 years (range 2.1-9.4) after ASA. Patients with high-grade atrioventricular block at follow-up had longer PR intervals at baseline [205 ms (200-230)] than the rest of the cohort [180 ms (140-200), P = 0.004] and a higher incidence of acute complete heart block (63 vs. 15%; P = 0.007) during ASA. A PR interval of at least 200 ms at baseline was associated with higher prevalence of high-grade atrioventricular block at follow-up (30 vs. 2%; P = 0.0013). The incidence of late-onset complete heart block was 1.5% per year after ASA.CONCLUSION: We found normalized atrioventricular conduction at long-term follow-up, suggesting recovery in 6 of 14 patients with a pacemaker implanted in relation to ASA. Permanent atrioventricular conduction abnormalities were associated with baseline PR intervals of at least 200 ms and acute persistent complete heart block during ASA.
AB - AIMS: Lesion of the atrioventricular conduction system is a well known adverse effect of alcohol septal ablation (ASA) in patients with obstructive hypertrophic cardiomyopathy (HCM). We assessed the atrioventricular conduction at long-term follow-up after ASA.METHODS: In patients with a pacemaker implanted for high-grade atrioventricular block after ASA, the atrioventricular conduction was assessed prospectively by ECGs and 48-h Holter recordings. In the remaining patients, the atrioventricular conduction was analysed retrospectively for comparison.RESULTS: A total of 24 (28%) of 87 patients with obstructive HCM without a pacemaker at baseline had a pacemaker implanted due to high-grade atrioventricular block after ASA. Ten of these patients were not available for follow-up. Holter recordings in the remaining 14 patients revealed normalized atrioventricular conduction in 6 patients 6.2 years (range 2.1-9.4) after ASA. Patients with high-grade atrioventricular block at follow-up had longer PR intervals at baseline [205 ms (200-230)] than the rest of the cohort [180 ms (140-200), P = 0.004] and a higher incidence of acute complete heart block (63 vs. 15%; P = 0.007) during ASA. A PR interval of at least 200 ms at baseline was associated with higher prevalence of high-grade atrioventricular block at follow-up (30 vs. 2%; P = 0.0013). The incidence of late-onset complete heart block was 1.5% per year after ASA.CONCLUSION: We found normalized atrioventricular conduction at long-term follow-up, suggesting recovery in 6 of 14 patients with a pacemaker implanted in relation to ASA. Permanent atrioventricular conduction abnormalities were associated with baseline PR intervals of at least 200 ms and acute persistent complete heart block during ASA.
KW - Ablation Techniques
KW - Aged
KW - Atrioventricular Block
KW - Cardiomyopathy, Hypertrophic
KW - Electrocardiography
KW - Ethanol
KW - Female
KW - Follow-Up Studies
KW - Heart Conduction System
KW - Humans
KW - Male
KW - Middle Aged
KW - Pacemaker, Artificial
KW - Prospective Studies
U2 - 10.2459/JCM.0b013e3283638073
DO - 10.2459/JCM.0b013e3283638073
M3 - Journal article
C2 - 24662414
VL - 15
SP - 214
EP - 221
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 3
ER -
ID: 138623897