ABSTRACT
Introduction About 25% of patients with hypertrophic cardiomyopathy (HCM) have left ventricular outflow obstruction under resting conditions.1,2 Medical therapy with negative inotropic drugs may alleviate symptoms in many of these patients; however, a certain number may remain refractory to drug therapy. This subset of patients may represent 5-10% of the total population with this disease.3 Surgical myectomy has been shown to reduce outflow gradients, and has been practiced since the 1960s. Some patients may, however, not be regarded as favorable candidates for this major intervention because of advanced age, concomitant medical conditions, or previous cardiac surgery.4 In 1994, a catheter treatment using absolute alcohol to induce a myocardial infarction localized to the interventricular septum was introduced as an alternative to surgery. Since the first series of three patients reported in 1995,5 there has been growing enthusiasm for this technique. During the first 5 years this technique was performed in over 800 cases,6 the number is now several thousand.
