1st Department of Coronary Artery Disease and 2nd Catheterization Laboratory, Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
Clin Res Cardiol. 2010 May;99(5):285-92. doi: 10.1007/s00392-010-0116-z. Epub 2010 Feb 11.
Percutaneous alcohol septal ablation (ASA) becomes an alternative option of treatment for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). The procedure relieves left ventricular outflow tract obstruction, but produces a myocardial scar in patients who already have a substrate for life-threatening ventricular arrhythmia.
To examine the effect of ASA on the occurrence of non-sustained ventricular tachycardia (nsVT) on 24 h ambulatory Holter monitoring in HOCM patients.
Sixty-one consecutive patients (34 males, mean age 48 years), who underwent ASA between 1997 and 2003 were analyzed. Holter recordings were performed in each patient before and after ablation.
Follow-up ranged from 60 to 125 months (median 116 months). The mean number of Holter recordings per patient was 2.7 (range 1-11) before and 8.3 (range 2-23) after ASA (p < 0.001). Non-sustained ventricular tachycardia occurred in 14 patients before and 27 patients after ASA (23 vs. 44%, p = 0.01). The percentage of Holter recordings with nsVT before and after ablation was similar (14.5 vs. 15.7%, p = 0.56, respectively). No difference was observed between the number of nsVT per Holter recording before and after ablation (0.21 vs. 0.24%, p = 0.65, respectively). The percentage of patients with nsVT after ASA was comparable to the proportion of patients with nsVT in a control group consisting of 705 patients with hypertrophic cardiomyopathy under follow-up at our institution (44.3 vs. 43.2%, p = 0.91). There was no significant difference in percentage of Holter recordings with nsVT with respect to sex, amount of alcohol used during ASA, peak creatine phosphokinase level, and gradient reduction at rest.
Alcohol septal ablation affected neither the percentage of Holter recordings with nsVT nor the number of nsVT episodes per Holter recording among HOCM patients.
经皮酒精室间隔消融术（ASA）成为肥厚型梗阻性心肌病（HOCM）有症状患者的一种治疗选择。该手术可缓解左心室流出道梗阻，但在已经存在危及生命的室性心律失常发生基质的患者中会产生心肌瘢痕。
检查 ASA 对 HOCM 患者 24 小时动态 Holter 监测中非持续室性心动过速（nsVT）发生的影响。
分析了 1997 年至 2003 年间接受 ASA 的 61 例连续患者（34 例男性，平均年龄 48 岁）。每位患者在消融前后均进行 Holter 记录。
随访时间为 60 至 125 个月（中位数 116 个月）。每位患者的平均 Holter 记录次数为消融前 2.7 次（范围 1-11 次）和消融后 8.3 次（范围 2-23 次）（p<0.001）。消融前发生非持续室性心动过速的患者有 14 例，消融后有 27 例（23%比 44%，p=0.01）。消融前后 Holter 记录中发生 nsVT 的百分比相似（分别为 14.5%和 15.7%，p=0.56）。消融前后 Holter 记录中 nsVT 的数量也没有差异（分别为 0.21%和 0.24%，p=0.65）。消融后发生 nsVT 的患者比例与我们机构随访的 705 例肥厚型心肌病患者中的 nsVT 患者比例相当（44.3%比 43.2%，p=0.91）。在性别、ASA 期间使用的酒精量、肌酸磷酸激酶峰值水平和休息时梯度降低方面，Holter 记录中发生 nsVT 的百分比均无显著差异。
ASA 既不会影响 HOCM 患者 Holter 记录中发生 nsVT 的百分比，也不会影响 Holter 记录中发生 nsVT 的次数。
