PTSMA (Percutaneous Transluminal septal myocardial ablation) is a procedure to hypertrophic cardiomyopathy (HCM) and heart palpitations and failure. This procedure is used when the patient is not responding to traditional medical therapy. Through a wire balloon, two ml of alcohol is introduced into the targeted blood vessel. Continuous ECG monitoring is done throughout the process. PTSMA is a safe, feasible and effective method to reduce pressure on the heart walls.