Hypertrophic Cardiomyopathy Treatments

 

When you come to NewYork-Presbyterian for the treatment of hypertrophic cardiomyopathy, we assess your heart and your overall health to determine which treatment is best for you. Your care may include one or more of the therapies below.

 

Medical Therapies

We offer medications to control the way your heart contracts, to regulate your heartbeat, and/or to reduce your risk of blood clots. These drugs include amiodarone, beta-adrenergic blockers, antiarrhythmic drugs, calcium channel blockers, and blood thinners.

 

Lifestyle Changes

We may recommend that you get an appropriate level of exercise, follow a heart-healthy diet, avoid smoking and stimulant street drugs, manage your stress, and provide other guidance to reduce your risk of complications associated with hypertrophic cardiomyopathy.

 

Genetic Counseling

Since hypertrophic cardiomyopathy can run in families, we offer genetic testing and counseling, should you wish to receive it. Your family can receive education about what kinds of activities to avoid because they stress the heart, and we can advise family members who might benefit from a pacemaker or implantable cardioverter defibrillator (ICD).

 

Interventional Cardiology: Alcohol Septal Ablation

This treatment is an option for people whose hypertrophic cardiomyopathy cannot be treated well with medication but who cannot have surgery. Your doctor inserts a balloon catheter into an artery in your groin and guides it toward the small artery that supplies blood to the wall between your right and left ventricles (the interventricular septum). Your doctor introduces a small amount of pure alcohol into this artery, which damages the abnormally thickened septum in a careful controlled way. Your septum becomes replaced by a thinner wall of scar tissue that reduces the obstruction and improves the overall function of your heart. Many of our patients tell us they feel immediate improvement of their symptoms, and most continue to improve for many months afterward.

 

Surgery

Septal myectomy

This surgery has long been considered the gold standard to relieve obstruction in a hypertrophic heart. During this open-heart surgery, we remove damaged muscle tissue from the wall of your damaged ventricle. Our surgeons are among the most experienced surgeons performing septal myectomy today. Higher survival rates are reported in centers that perform the highest volume of this surgery.

Pacemakers and implantable cardioverter defibrillators (ICDs)

We recommend that some people with hypertrophic cardiomyopathy have a pacemaker or ICD implanted under the skin in the chest. A pacemaker ensures that your heart beats at a normal and appropriate rate. An ICD continuously monitors your heartbeat and sends an electric shock to restore a normal heartbeat if your heart is beating chaotically or very fast. At NewYork-Presbyterian, we offer the latest advances in pacemaker and ICD technology. These devices can be life-saving for people with hypertrophic cardiomyopathy who are at risk for sudden cardiac death or experience life-threatening arrhythmias.

Robotic heart surgery

Our teams include experts in the use of totally robotic endoscopic surgery to perform septal myectomy and pacemaker lead placement. Robotic surgery is a form of minimally invasive heart surgery that uses the more dexterous robotic instruments and a robotically controlled 3D camera to perform surgery through very small incisions—with a degree of precision and visualization that would be difficult or impossible without them.

 

Heart Transplantation

Heart transplantation may be an option for some patients with very advanced hypertrophic cardiomyopathy. Doctors in our Heart Failure and Transplantation Program are making continuous advances in medical therapies, surgical techniques, immunologic therapies, imaging methods, and device development.

  • Our heart transplant team expanded the usual criteria by which donor hearts are accepted. As a result, waiting times for a heart transplant are lower here than at other centers in the region; the ability to transplant sooner translates into better outcomes for our patients.
  • Our team pays attention to your quality of life during the entire transplant process, your evaluation as a transplant candidate, your surgical care in the hospital, and your follow-up treatments as a transplant recipient.