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Short time effects of two radiofrequency ablation methods on hypertrophic obstructive cardiomyopathy

Yin-Ge He1, Yong Dong1, Shao-Hua Yang1

  • 1Department of Cardiology, Zhengzhou, China.

Clinical Cardiology
|March 5, 2024
PubMed

Insights

Percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) shows better short-term results than endocardial radiofrequency septal ablation (ERSA) for hypertrophic obstructive cardiomyopathy (HOCM). PIMSRA significantly reduced outflow tract gradients and mitral regurgitation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a condition where the heart muscle thickens, obstructing blood flow.
  • Radiofrequency ablation is an established treatment modality for HOCM.
  • Two primary procedures exist: percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) and endocardial radiofrequency septal ablation (ERSA).

Purpose of the Study:

  • To compare the short-term efficacy of PIMSRA versus ERSA in patients with drug-refractory HOCM.
  • To evaluate the impact of each procedure on left ventricular outflow tract (LVOT) gradient, mitral regurgitation (MR), left atrial diameter (LAD), and left ventricular ejection fraction (LVEF).

Main Methods:

  • Retrospective analysis of 28 patients with drug-refractory HOCM.
  • 12 patients underwent PIMSRA, and 16 patients underwent ERSA.
  • Short-term outcomes were assessed at 30-day follow-up.

Main Results:

  • PIMSRA demonstrated a significantly greater reduction in resting LVOT peak gradient compared to ERSA (22.25 mmHg vs. 47.75 mmHg, p < .01).
  • Only PIMSRA led to a significant decrease in mitral regurgitation (MR) (area reduced from 10.13 mm² to 3.65 mm², p < .01).
  • PIMSRA also resulted in significant reductions in LAD (43.58 mm to 37.08 mm, p = .03) and LVEF% (65.75% to 60.83%, p = .03).

Conclusions:

  • PIMSRA offers a more favorable early treatment effect for HOCM compared to ERSA.
  • The findings suggest PIMSRA may be a superior option for managing drug-refractory HOCM in the short term.
Abstract

Keywords:
endocardial radiofrequency septal ablationhypertrophic obstructive cardiomyopathypercutaneous intramyocardial septal radiofrequency ablationsystolic anterior motion

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