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Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: A Pilot Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00035386
Recruitment Status : Completed
First Posted : May 3, 2002
Last Update Posted : March 4, 2008
Information provided by:
National Institutes of Health Clinical Center (CC)

Brief Summary:

This study will test the feasibility of a modified procedure for treating obstructive hypertrophic cardiomyopathy (OHC). Patients with OHC have a thickening of the heart muscle that obstructs blood flow out of the heart, causing breathlessness, chest pain, palpitations, tiredness, lightheadedness, and fainting.

The current treatment for OHC is a procedure called alcohol septal ablation (also percutaneous transluminal septal ablation, or PTSA), which involves injecting a small amount of alcohol into a tiny artery that supplies the part of muscle causing blood flow obstruction. The success of PTSA is limited, however, by problems of heart anatomy and the ability to find the appropriate artery to inject. Modifying the procedure by injecting the alcohol through the wall of the lower right chamber of the heart may improve its safety and effectiveness. The new technique requires positioning a catheter (a flexible tube) into the appropriate area of the heart. This study will test the ability to accurately guide the catheter to that area.

Patients with OHC 18 years of age and older who are scheduled to have a cardiac catheterization may be eligible for this study. At the end of the catheterization procedure, participants will undergo intra-cardiac echocardiographic imaging. For this test, one of the catheters placed in the femoral artery (at the top of the leg) for cardiac catheterization will be substituted for a larger one. Through this catheter, a special catheter will be introduced and advanced to the heart to provide images. This pilot feasibility study does not involve injection of alcohol.

Condition or disease Intervention/treatment Phase
Hypertrophic Cardiomyopathy Procedure: trans-right ventricular alcohol septal ablation (TRVASA) Phase 2

Detailed Description:
Patients with obstructive hypertrophic cardiomyopathy (HCM) and drug-refractory symptoms have traditionally been referred for cardiac surgery to widen the left ventricular (LV) outflow tract. More recently, percutaneous transluminal septal ablation (PTSA) has also been shown to thin the subvalvular septum and thereby to reduce LV outflow pressure gradients and to improve symptoms in obstructive HCM. However, this procedure is not infrequently limited by septal coronary artery anatomy and inability to identify and cannulate the appropriate artery that supplies the septal region of interest. Some attempts are also associated with coronary artery dissection, particularly, if there is associated coronary artery disease. A trans-right ventricular (RV) alcohol septal ablation (TRVASA) would significantly simplify the procedure, and increase its safety. The purpose of this study is to initially test our ability to visualize and guide a delivery catheter to a targeted part of the anterior interventricular septum involved in the generation of the LV outflow obstruction using intracardiac echocardiography (ICE). No therapy is intended: alcohol will not be injected into the septum in this initial study.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 12 participants
Primary Purpose: Treatment
Official Title: Trans-Right Ventricular Approach to Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: A Pilot Feasibility Study
Study Start Date : April 2002
Study Completion Date : April 2003

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


Patients of either gender, aged 18-85 years.

Symptomatic patients receiving clinically indicated evaluation for cardiomyopathy and found to have obstructive HCM.

LV outflow tract gradient greater than 30 mm Hg at rest by echocardiography or cardiac catheterization.


Positive pregnancy test.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00035386

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United States, Maryland
National Heart, Lung and Blood Institute (NHLBI)
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
Layout table for additonal information Identifier: NCT00035386    
Other Study ID Numbers: 020125
First Posted: May 3, 2002    Key Record Dates
Last Update Posted: March 4, 2008
Last Verified: April 2003
Keywords provided by National Institutes of Health Clinical Center (CC):
Outflow Obstruction
Hypertrophic Cardiomyopathy
Obstructive HCM
Additional relevant MeSH terms:
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Cardiomyopathy, Hypertrophic
Heart Diseases
Cardiovascular Diseases
Pathological Conditions, Anatomical
Aortic Stenosis, Subvalvular
Aortic Valve Stenosis
Heart Valve Diseases