Septal ablation complications

Table 4 Reported complication after surgical myectomy or septal ablation...

Septal ablation related mortality at experienced centers is currently 1% to 2%, similar to that of surgical myectomy (Table 4). Conduction system abnormalities are relatively common complications of septal ablation, Permanent right bundle branch block occurs in about 50% of patients and transitory complete heart block in 60% and permanent pacemakers required for high grade atrioventricular block in about 5% to 20%, Concerns of late occurrence of complete heart block following septal ablation mandates in-patient monitoring for 4 to 5 days,... 

A profound complication of septal ablation is anterior Ml due to ethanol reflux from the septal perforator down the left anterior descending artery. This can be avoided by careful position of the balloon and angiographic monitoring. Other rare complications include coronary dissection, perforation, thrombosis, and spasm. 

Ablation of the myocardium using alcohol is another alternative to surgery. Septal ablation with alcohol results in the same type of outcomes as seen with myectomy. Long-term follow-up is limited because this procedure has been used for less than a decade. Since it is a percutaneous procedure (similar to cardiac catheterizations), it is being done more frequently than myectomy. There is some concern that the risk for arrhythmia-related cardiac events may increase following alcohol ablation. Long-term follow-up is needed to assess this risk. Complete heart block is a common complication of septal... 

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