HOCM to be treated with Alochol Ablation

Hi
I am having a gradient of around 48-50 and have been treated with HOCM medicines for last 7 years and taking nebicard, nebistar, concor and now on Calaptine... Felt good the calaptine initially...
my questions..
1. after changing beta blocker, be it any, initially it feels very good like the case of having Calaptine 80, but slowly and steadily the pain again starts and now have moved to Calaptine 120..dont know why,,,
2, doctor have suggested Alcohol ablation...want to know how much successful it is..
3. if pace maker is installed, then how the life will be afterwards...what are the pros and cons of it.

regards
Ashish Ajmani.

[kenkeith]

To give some perspective:  For HCOM patients who are poor surgical candidates or those who choose not to undergo open-heart surgery, alcohol ablation is another option. Septal ablation is performed in the catheterization laboratory. Alcohol is instilled into the first septal perforator or the perforator that supplies the proximal septum, resulting in a controlled myocardial infarction. Alcohol acts as a toxic agent to the coronary artery and surrounding myocardium, effectively infarcting the cardiac muscle supplied by the septal perforator. Consequently, the muscle shrinks and the LVOT obstruction lessens.

Most alcohol ablations have been performed on elderly, suboptimal surgical candidates. There are some guidelines: It is generally preferred that the septum be between 1.8 cm and 3.0 cm to provide a safety margin; if the septum is too thick, favorable ablation results may be difficult to attain.... Complications of alcohol ablation include complete heart block (requiring a permanent pacemaker), a large anterior wall myocardial infarction, ventricular tachycardia or fibrillation, and pericarditis.

The risk of alcohol ablation include a 2%-4% procedural mortality rate and a 9%-27% incidence of patients requiring permanent pacemakers. Like septal myectomy (open heart surgery), alcohol ablation has not been shown to improve survival due to the lack of randomized controlled trials and a suitable control population. However, septal myectomy does result in both short-term and long-term significant decreases in the Left ventricle output tract (LVOT) gradient as well as a significant improvement in New York Heart Association classification.

[ashishajmani]

thanks for replying in...I am 31...........what's your adivse for ablation, either to go for alcohol ablation or myectomy....in a fix right now...or should I do Pranayam...continuously...have you heard of patients doing yoga and getting HOCM cleared ...suggest please...

[kenkeith]

You are relatively young and myectomy has a better track record for no complications, but that may be involve the quality of care and experience of the doctors.  No, I haven't heard yoga helping HOCM.