Alcohol septal ablation complicated by complete heart block and permanent pacemaker failure

Alcohol septal ablation is a novel catheter-based technique for the treatment of obstructive hypertrophic cardiomyopathy. Complete heart block complicates the procedure in 7%-30% of cases and necessitates the prophylactic insertion of a temporary pacing wire in all patients who do not have a permanent pacemaker. We describe a case of alcohol septal ablation complicated by complete heart block and failure to capture by both a permanent pacemaker and an implantable cardioverter defibrillator (ICFD) with pacing capabilities.