Alcohol
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Ventricular tachyarrhythmia and sudden cardiac death: 4 case reports In a retrospective study conducted from May 2003 to April 2019 involving 243 patients, 4 patients [sexes not stated] aged 63–88 years were described, who developed ventricular tachyarrhythmia (3 patients) and sudden cardiac death (1 patient) following alcohol septal ablation for hypertrophic cardiomyopathy [not all outcomes stated]. Patient 1: An 83-year-old patient, who had hypertrophic cardiomyopathy, underwent alcohol septal ablation (ASA) with slow infusion of alcohol [ethanol] 1.5cc by using 1 septal perforator. The patient’s post ASA gradient was 0-5mm Hg. On the following day of ASA, the patient developed ventricular tachyarrhythmia as a complication of ASA. The patient had no haemodynamic instability and did not require cardioversion. However, the patient underwent new implantable cardioverter-defibrillator placement post ASA. Patient 2: A 73-year-old patient, who had hypertrophic cardiomyopathy, underwent alcohol septal ablation (ASA) with slow infusion of alcohol [ethanol] 1.8cc by using 1 septal perforator. After 2 days of ASA, the patient developed ventricular tachyarrhythmia as a complication of ASA. The patient’s condition further worsened to haemodynamic instability and required cardioversion. Additionally, the patient underwent new implantable cardioverter-defibrillator placement post ASA. Patient 3: A 63-year-old patient, who had hypertrophic cardiomyopathy, underwent alcohol septal ablation (ASA) with slow infusion of alcohol [ethanol] 2.8cc by using 2 septal perforator. The patient was discharged. After 4 days of ASA, the patient developed ventricular tachyarrhythmia as a complication of ASA. The patient was readmitted due to syncopal episode with persistent VT. The patient’s condition further worsened to haemodynamic instability and required cardioversion. Additionally, the patient was recommended for implantable cardioverter-defibrillator placement post ASA; however, the patient deferred it. Patient 4: An 88-year-old patient, who had hypertrophic cardiomyopathy, underwent alcohol septal ablation (ASA) with slow infusion of alcohol [ethanol] 1.9cc by using 1 septal perforator. The patient’s post ASA gradient was 10-14mm Hg. After 15 days of ASA, the patient had sudden cardiac death as a complication of ASA. El-Sabawi B, et al. Temporal Occurrence of Arrhythmic Complications After Alcohol Septal Ablation. Circulation: Cardiovascular Interventions 13: e008540, No. 2, Feb 803503503 2020. Available from: URL: http://doi.org/10.1161/CIRCINTERVENTIONS.119.008540
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Reactions 26 Sep 2020 No. 1823
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