This minimally invasive procedure involves light sedation, followed by the slow injection of 100 percent alcohol via catheter into one of the branches of the heart artery that leads to the enlarged septum. The high concentration of alcohol (1-3 ml) is delivered directly to the thickened heart muscle and left in place for several minutes. Thin scar tissue forms and starts to improve blood flow to and away from the heart.
During the procedure, the interventional cardiologists observe the heart from all sides via X-ray fluoroscopy and echocardiography. This enables monitoring correct catheter placement and the destruction of only the necessary cells to reduce the thickening heart mass.
A small percentage of patients (five to ten percent) can develop significant slowing of the heart rate (complete heart block) and, thus, a temporary pacemaker is inserted to the heart from the neck and is left for one-two days post procedure.
An alcohol septal ablation is performed in the cardiac catheterization laboratory (or cath lab) by the interventional cardiologist and a team of cardiovascular nurses and technicians. The procedure usually lasts about two hours, but the preparation and recovery time add several hours. You may stay in the hospital for several days to be observed by the medical staff.