TY  - EJOU
AU  - Șoșdean, Ș. Raluca
AU  - Pașcalău, P. Laurențiu
AU  - Mircea, M. Monica
AU  - Ionică, I. Loredana
AU  - Baneu, B. Petru
AU  - Pescariu, P. Alexandru
AU  - Sturza, S. Adrian
AU  - Mornoș, M. Cristian
AU  - Pescariu, P. Sorin
TI  - Late Complications after Alcohol Septal Ablation in a Patient with Hypertrophic Obstructive Cardiomyopathy
T2  - Timisoara Medical Journal

PY  - 2021
VL  - 2020
IS  - 2
SN  - 1583-526X

AB  - (1) Background: Complete atrioventricular block is a well-known complication of alcohol ablation as a septal reduction therapy, implemented in selected patients with hypertrophic obstructive cardiomyopathy (HOCM). It usually occurs during or immediately after the intervention. Rare cases of late complete atrioventricular block (CAVB) have been reported, but data are still scarce in the literature regarding this issue. (2) Case report: We report the case of a 70-year-old male patient, with mild aortic stenosis, but with a significantly degenerated valve and perivalvular tissue, and a nonspecific intraventricular conduction delay, which developed intensely symptomatic CAVB, four months after alcohol septal ablation (ASA) for HOCM, along with left ventricular pressure gradient recurrence. Both problems were resolved by implantation of a dual chamber pacemaker, with pacing optimization to a short atrioventricular interval, along with a maximal tolerated betablocker therapy. With the description of the patient’s treatment and evolution in comparison with other reports and studies, this case report highlights the fact that a close clinical, electrical and echocardiographic surveillance is warranted for this kind of patients, as late CAVB may be a life-threatening complication. Previous electrical conduction problems and degenerated aortic valve and perivalvular tissue may be predisposed for this type of complication, independent of betablocker therapy. This treatment has several other beneficial effects and thus it should not be interrupted after the procedure.
KW  - obstructive hypertrophic cardiomyopathy
KW  - alcohol septal ablation
KW  - abnormal electrical conduction
KW  - late complete AV block
KW  - LVOT pressure gradient recurrence
KW  - dual chamber pacemaker implantation
DO  - 10.35995/tmj20200203