Alcohol Ablation

What is alcohol ablation?

Patients with hypertrophic obstructive cardiomyopathy (HOCM) have abnormally thickened walls of the heart's main pumping chamber (the left ventricle). The interventricular septum — the wall of muscle that separates the two ventricles of the heart — is particularly thickened. This thickened wall can interfere with the function of the mitral valve and can block the flow of blood out of the heart. The inefficient outflow of blood causes the pressure in the heart to increase, thereby causing the left ventricle to work harder. This results in further thickening of the walls of the left ventricle over time. Symptoms associated with HOCM can include chest pain, shortness of breath, palpitations, syncope (sudden fainting), and even sudden death.

Treatments for HOCM include medication to control the heart's contraction, insertion of pacemakers to prevent arrhythmias, and — when medications fail — surgical redirection of the thickened septum. Interventional radiologists offer alcohol septal ablation as an alternative to surgery in select patients. This relatively new treatment for HOCM actually reduces the obstruction and improves blood flow out of the heart. In addition, it often improves the function of the mitral valve.

What can I expect during this procedure?

During alcohol ablation, a balloon catheter is inserted in the groin and is led to the heart. With echocardiographic guidance, the catheter is led to the small artery that supplies the interventricular septum. A small amount of pure alcohol is introduced into the vessel. This results in carefully controlled damage to that part of the abnormally thickened septum. A thinner wall of scar tissue that reduces the obstruction and improves the overall function of the heart will replace the septum. Many patients feel immediate improvement of their symptoms; the majority continue to improve over many months.