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Heart Consult

Alcohol Septal Ablation

Alcohol septal ablation is a minimally invasive treatment that is performed in order to relieve the symptoms and improve the status of the patients suffering from hypertrophic cardiomyopathy (HCM). HCM is a genetic condition characterised by primary hypertrophy of the left ventricle. The most common observations are angina, dyspnoea, and sometimes even sudden death.

Alcohol Septal Ablation

Over the last one decade, alcohol septal ablation (ASA) has been developed as an alternative to open heart surgery. Alcohol septal ablation involves the injection of hundred percent alcohol into the thickened septal muscle. This technique produces a decrease in the outflow area obstruction by injecting alcohol into the appropriate septal artery.  The main reason for performing alcohol septal ablation is to reduce the symptoms of HCM. This procedure is performed using cardiac catheterization.  It is suitable for patients who have severe symptoms. 

Alcohol septal ablation is performed in the cardiac catheterization laboratory. The cardiologists who perform alcohol septal ablation need to undergo a special training before actually practising it.  This procedure is more or less the same as coronary angioplasty. Initially, the septal arteries are localised with the help of wires and balloons. Once the diseased muscle is recognized, a small amount of alcohol is injected into the artery. When this small amount of alcohol is injected, the patient undergoing this procedure is likely to develop a mild heart attack which is accompanied by chest pain and uneasiness. However, analgesic is given as the situation demands. This entire procedure may last for about thirty minutes, after which the patient is kept under observation for three to four days in the hospital.  
alcohol septal ablation image
Uses of Alcohol Septal Ablation 
Alcohol septal ablation procedure results in immediate, partial relief of the obstruction for a period of up to 1 year. Majority of the patients who underwent this procedure experienced several improvements and relief in the symptoms. Most of the patients will have a vast improvement in the outflow tract and mitral regurgitation. The patients will also experience relief in breathing related problems, chest pain, etc. On top of it, when compared to other traditional methods, alcohol septal ablation is less invasive with very little or no risks involved in the entire procedure.  
Limitations of Alcohol Septal Ablation 
  • Lack of accuracy in targeting the whole area that causes obstruction.
  • Alcohol ablation tends to produce right bundle-branch block. 
  • There are chances of having a complete heart block 
  • Serious ventricular arrhythmias.
  • Inability to handle additional cardiac lesions.

Side effects 

There are some side effects that are observed with alcohol septal ablation. The most common one is the blocking of the heart. Yes, there are chances of complete heart block which will require implantation of a permanent pacemaker. The other side effects are bleeding, irregular heartbeat, and infection . There are even cases, wherein some patients suffered allergic reactions to the alcohol injected.  





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