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Delayed Occurrence of Unheralded Phase IV Complete Heart Block After Ethanol Septal Ablation for Symmetric Hypertrophic Obstructive Cardiomyopathy
Author(s) -
WYKRZYKOWSKA JOANNA J.,
KWAKU KEVIN,
WYLIE JOHN,
MANNING WARREN J.,
JOSEPHSON MARK E.,
ZIMETBAUM PETER,
LAHAM ROGER J.
Publication year - 2006
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2006.00416.x
Subject(s) - medicine , alcohol septal ablation , obstructive cardiomyopathy , cardiology , heart block , hypertrophic cardiomyopathy , ablation , cardiomyopathy , complication , left bundle branch block , bundle branch block , anesthesia , electrocardiography , heart failure
Ethanol septal ablation has emerged as a less invasive alternative to surgical myomectomy for treatment of asymmetric hypertrophic obstructive cardiomyopathy (ASH). The procedure has very low mortality, but high‐degree AV conduction block is a frequent complication. Prior studies have documented baseline left bundle branch block and high volume of ethanol injection (greater than 4 mL) as risk factors. Complete heart block is often preceded by postprocedure conduction abnormalities and generally develops within 48 hours after ethanol ablation. We present a unique case of a patient with symmetric hypertensive hypertrophic obstructive cardiomyopathy (SHOCM) who developed phase IV complete heart block >96 hours postprocedure without preceding conduction abnormalities or other classic risk factors.3
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