Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care
1Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr University Bochum, Georgstraße 11, 32545 Bad Oeynhausen, Germany.
Insights
Hypertrophic cardiomyopathy (HCM) is a common hereditary heart condition. This review focuses on obstructive HCM (HOCM) treatments, particularly percutaneous septal ablation, showing comparable outcomes to other methods.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) is a prevalent hereditary cardiac condition.
- HCM presents as obstructive (HOCM) or non-obstructive (HNCM) phenotypes.
- Symptoms range from exercise intolerance to sudden cardiac death, necessitating accurate diagnosis and risk stratification.
Purpose of the Study:
- To review current treatment options for obstructive hypertrophic cardiomyopathy (HOCM).
- To focus on the efficacy and outcomes of percutaneous septal ablation for HOCM.
- To compare percutaneous septal ablation with other treatment modalities for HOCM.
Main Methods:
- Review of literature data on hypertrophic cardiomyopathy treatments.
- Analysis of a personal series of approximately 600 HOCM cases treated with percutaneous septal ablation.
- Comparison of outcomes including procedural mortality, clinical efficacy, and long-term results.
Main Results:
- Percutaneous septal ablation demonstrates largely comparable outcomes to other treatment options for HOCM.
- The procedure shows comparable procedural mortality, clinical efficacy, and long-term results.
- This suggests percutaneous septal ablation is a viable treatment option for HOCM.
Conclusions:
- Percutaneous septal ablation is an effective treatment for obstructive hypertrophic cardiomyopathy (HOCM).
- Outcomes of percutaneous septal ablation are comparable to other therapeutic approaches.
- This review supports percutaneous septal ablation as a key management strategy for HOCM.
Abstract:
Hypertrophic cardiomyopathy (HCM) is one of the more common hereditary cardiac conditions. According to presence or absence of outflow obstruction at rest or with provocation, a more common (about 60-70%) obstructive type of the disease (HOCM) has to be distinguished from the less common (30-40%) nonobstructive phenotype (HNCM). Symptoms include exercise limitation due to dyspnea, angina pectoris, palpitations, or dizziness; occasionally syncope or sudden cardiac death occurs. Correct diagnosis and risk stratification with respect to prophylactic ICD implantation are essential in HCM patient management. Drug therapy in symptomatic patients can be characterized as treatment of heart failure with preserved ejection fraction (HFpEF) in HNCM, while symptoms and the obstructive gradient in HOCM can be addressed with beta-blockers, disopyramide, or verapamil. After a short overview on etiology, natural history, and diagnostics in hypertrophic cardiomyopathy, this paper reviews the current treatment options for HOCM with a special focus on percutaneous septal ablation. Literature data and the own series of about 600 cases are discussed, suggesting a largely comparable outcome with respect to procedural mortality, clinical efficacy, and long-term outcome.
More Related Videos
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
Related Concept Videos
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
01:30Cardiomyopathy II: Dilated Cardiomyopathy