BACKGROUND The temporal occurrence of arrhythmic complications after alcohol septal ablation (ASA) is unclear. As a result, the appropriate time to monitor patients after ASA is controversial. The purpose of this study is to determine the temporal occurrence of complete heart block (CHB) and ventricular tachyarrhythmia (VT) after ASA to better understand when patients can be safely discharged. METHODS Consecutive patients treated with ASA for hypertrophic cardiomyopathy from 2003 to 2019 at a tertiary referral center were reviewed retrospectively. The incidence and timing of CHB or sustained VT within 30 days post-ASA were assessed. RESULTS A total of 243 patients were included in this study. Mean maximal septal thickness was 19.0±3.9 mm, and total volume of ethanol injected was 1.7±0.6 mL. CHB occurred in 59 (24.3%) patients, including transient CHB in 33 (13.6%) and permanent in 26 (10.7%). The initial episode of CHB occurred within 24 hours post-ASA in 51 (21.0%) patients, between 24 and 48 hours in 3 (1.2%), between 48 and 72 hours in 3 (1.2%), and after 72 hours in 2 (0.8%). New permanent pacemaker was placed in 46 (18.3%). Presence of baseline bundle branch block and age ≥70 were significantly associated with CHB but not CHB presenting after 24 hours. VT occurred in 3 (1.2%) patients, including 1 (0.4%) within 24 hours, 1 (0.4%) between 24 and 48 hours, and 1 (0.4%) after 72 hours. VT required cardioversion in 2 patients and new implantable cardioverter-defibrillator placement in 2. CONCLUSIONS The incidence of CHB or VT presenting after 72 hours post-ASA was low. These findings suggest that timely discharge of patients without evidence of early conduction disturbances after ASA can be considered as a potentially safe management strategy, especially in patients without preexisting conduction abnormalities.

中文翻译：

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酒精中隔消融后心律失常并发症的暂时发生。

背景技术酒精中隔消融（ASA）后心律失常并发症的暂时发生尚不清楚。因此，在ASA后监测患者的适当时间存在争议。这项研究的目的是确定ASA后完全性心脏传导阻滞（CHB）和室性快速性心律失常（VT）的时间发生，以更好地了解患者何时可以安全出院。方法回顾性分析2003年至2019年在三级转诊中心接受ASA治疗的肥厚型心肌病的连续患者。评估ASA后30天内CHB或持续性VT的发生率和时机。结果本研究共纳入243例患者。平均最大间隔厚度为19.0±3.9 mm，注射的乙醇总量为1.7±0.6 mL。CHB发生在59（24.3％）位患者中，包括暂时性CHB（33（13.6％））和永久性（26）（10.7％）。CHB的初始发作发生在ASA后24小时内的51名患者中（21.0％），其中3名患者（24％）在24至48小时之间，3名患者（1.2％）中48至72小时，2名患者72小时后（0.8％）。新的永久性起搏器排在第46位（18.3％）。基线束分支阻滞的存在和年龄≥70岁与CHB显着相关，但24小时后CHB不存在。3例（1.2％）患者发生VT，其中24小时内1例（0.4％），24至48小时内1例（0.4％），72小时后1例（0.4％）。2例患者需要VT复律，2例需要新的植入式心脏除颤器植入。结论结论ASA后72小时出现CHB或VT的发生率较低。