Ethanol septal ablation has emerged as a less invasive alternative to surgical myomectomy for treatment of hypertrophic obstructive cardiomyopathy (HOCM). The procedure has very low mortality, but complete heart block (CHB) is a common complication. Prior studies suggested existence of baseline characteristics, ECG features and procedural risk factors, which are highly predictor of CHB requiring permanent pacemaker after ethanol septal ablation. CHB is often preceded by postprocedure conduction abnormalities and generally develops within 48 h after ethanol ablation. We present a unique case of a patient with HOCM who developed a CHB on 8th day postprocedure without preceding conduction abnormalities or other classic risk factors.
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