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Alcohol septal ablation (ASA) is a minimally invasive heart procedure to treat hypertrophic cardiomyopathy (HCM). [1]It is a percutaneous, minimally invasive procedure performed by an interventional cardiologist to relieve symptoms and improve functional status in eligible patients with severely symptomatic HCM who meet strict clinical, anatomic and physiologic selection criteria.
Catheter ablation of most arrhythmias has a high success rate. Success rates for WPW syndrome have been as high as 95% [ 2 ] For Supraventricular tachycardia (SVT), single procedure success is 91% to 96% (95% Confidence Interval) and multiple procedure success is 92% to 97% (95% Confidence Interval). [ 3 ]
When performed properly, an alcohol septal ablation induces a controlled heart attack, in which the portion of the interventricular septum that involves the left ventricular outflow tract is infarcted and will contract into a scar. There is debate over which people are best served by surgical myectomy, alcohol septal ablation, or medical therapy.
a stimulator to electrically excite the heart and control the heart rate; ablation equipment to destroy abnormal tissue; an electroanatomic mapping system that tracks and records the catheter position in 3D and associated electrical signals; ready access to cardiac medications such as adenosine, atropine, dopamine, and isoproterenol
Ulrich Sigwart. Ulrich Sigwart (German: [ˈʊlʁɪç ˈziːkvaʁt]; born 9 March 1941) is a German retired cardiologist known for his pioneering role in the conception and clinical use of stents to keep blood vessels open, and introducing a non-surgical intervention, alcohol septal ablation for the treatment of hypertrophic obstructive cardiomyopathy.
The risks and benefits are weighed up before this is performed. Catheter ablation of the slow pathway, if successfully carried out, can potentially cure AVNRT with success rates of >95%, balanced against a small risk of complications including damaging the AV node and subsequently requiring a pacemaker. [8]
However, with proper treatment, including cessation of alcohol consumption and management of heart failure symptoms, the prognosis can improve significantly. [10] Research has shown that the mortality rate for people with ACM is higher than that of the general population, with a five-year survival rate of around 50%. [10]
Catheter ablation may be used to treat intractable ventricular tachycardia. It has a 60–90% success rate. [43] Unfortunately, due to the progressive nature of the disease, recurrence is common (60% recurrence rate), with the creation of new arrhythmogenic foci.