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July 18, 2026CJC OpenOpen Access

Only ~45% of HOCM patients paced for AV block after alcohol septal ablation remain pacemaker dependent.

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Why the study?

What is the rate of long-term pacemaker dependency in HOCM patients who receive a CIED for AV block after alcohol septal ablation?

Population

67 patients with hypertrophic obstructive cardiomyopathy who underwent alcohol septal ablation and…

Design

Cohort

Follow-up

≥6 weeks post-implantation

Key result

Long-term pacemaker dependency (>1% ventricular pacing) was observed in only 44.8% of HOCM patients who received a device for AV block after alcohol septal ablation.

Authors

SLSophia Schulze LammersDLDennis LawinAHA Hoyer

Discussion

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Member takes

Overview

May support selective CIED use post-ASA in HOCM; leaves open prospective validation of dependency rates.

Key Points

  • Examine long-term pacemaker dependency in HOCM patients after alcohol septal ablation due to AV block.
  • Retrospective analysis of 464 HOCM patients undergoing ASA from 2016 to 2023, assessing those needing CIED due to AV block.
  • Assessment of ventricular pacing was performed at ≥6 weeks post-implantation.
  • Logistic regression analyzed associations between baseline characteristics and pacemaker dependency.
  • Of 464 patients, 95 (20.5%) received a CIED, with 67 available for follow-up.
  • 30 patients (44.8%) exhibited >1% ventricular pacing; 9 (13.4%) were fully dependent on pacing.
  • Persistent AV block was more frequent in patients with pre-interventional left bundle branch block.

Study Design

Type

Cohort (n=67)

Structured PICO

What is the rate of long-term pacemaker dependency in HOCM patients who receive a CIED for AV block after alcohol septal ablation?

P
Population
67 patients with hypertrophic obstructive cardiomyopathy who received a cardiac implantable electronic device for AV block after alcohol septal ablation, followed for ≥6 weeks.
E
Exposure
Cardiac implantable electronic device (CIED) implantation
O
Outcome
Pacemaker dependency (defined as >1% ventricular pacing) assessed by CIED interrogation at ≥6 weeks post-implantationsurrogate

Long-term pacemaker dependency after alcohol septal ablation is unexpectedly low, suggesting AV conduction may recover and routine early device implantation could be reconsidered.

Limitations

  • Retrospective design
  • Small sample size requiring larger prospective studies

Cite This Study

Lammers et al. (2026) conducted a cohort in Hypertrophic obstructive cardiomyopathy (HOCM) (n=67). Alcohol septal ablation with subsequent CIED implantation was evaluated on Pacemaker dependency (>1% ventricular pacing). Long-term pacemaker dependency (>1% ventricular pacing) was observed in only 44.8% of HOCM patients who received a device for AV block after alcohol septal ablation.

synapsesocial.com/papers/6a5b39118167787360d24f11https://doi.org/10.1016/j.cjco.2026.06.021
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Corticosteroids reduce pacemaker implantation after alcohol septal ablation in oHCM patients2025
  2. 2Pacemaker dependency after transcatheter aortic valve implantation: a 15-year single-centre experience2026
  3. 3Predictors of pacemaker dependency after TAVI to guide early permanent pacemaker implantation timing2026
  4. 4Long-term conduction outcomes after valve surgery: incidence and predictors of persistent AV block and high ventricular pacing burden2026
  5. 5Baseline Echocardiographic Parameters Associated With Post‐Pacing Cardiomyopathy in Patients With Normal Left Ventricular Ejection Fraction Undergoing Pacemaker Implantation for Atrioventricular Block2026