The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on non-surgical reduction of myocardial septum.


This procedure is used to treat hypertrophic obstructive cardiomyopathy.

People with hypertrophic obstructive cardiomyopathy (HOCM) have abnormally thickened heart muscle. Thickening is usually most severe in the wall (septum) between the right and left ventricles and may cause obstruction to the flow of blood out of the left ventricle.

HOCM may cause chest pain, breathlessness, palpitations and syncope. People with HOCM have an increased risk of sudden death from heart attacks or abnormal heart rhythms.

Most people with HOCM are treated with medication. More invasive treatments may be considered in people who still get symptoms despite drug treatment.

The standard surgical treatment is ventricular septal myotomy-myectomy. This is an open surgical technique that requires cardiopulmonary bypass.  A small amount of muscle is removed from the septum to reduce its thickness and reduce obstruction.

Non-surgical ablation of the septum does not require open heart surgery or cardiopulmonary bypass. It involves inserting a catheter into the femoral artery and passing it up into the heart under X-ray control. Alcohol is injected into an artery supplying blood to the septum. This destroys a part of the septal muscle which then becomes thinner.

Coding and clinical classification codes for this guidance.