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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.
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.
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 ]
Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo Clinic found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation.
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]
Disadvantages include a high rate of complications, such as deep sternal wound infections, in some subgroups of patients—mainly obese and diabetic ones. The left radial artery and left gastroepiploic artery can be also used. Long-term patency is influenced by the type of artery used and intrinsic factors of the cardiac arterial circulation. [41]
From 2006 to 2010, alcohol-attributed deaths accounted for 11.7 percent of all Native American deaths, more than twice the rates of the general U.S. population. The median alcohol-attributed death rate for Native Americans (60.6 per 100,000) was twice as high as the rate for any other racial or ethnic group. [108]
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.