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Radiofrequency Ablation for Patients with Hypertrophic Obstructive Cardiomyopathy Accompanied by Severe Left

Lu Xu1, Chenglong Miao1, Pin Wang1

  • 1Department of Cardiovascular Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Anatolian Journal of Cardiology
|November 25, 2024
PubMed

Insights

CARTOSound-guided radiofrequency ablation (RFA) effectively reduced symptoms and left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) patients. This nonsurgical treatment offers a promising option for HOCM management.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) presents limited nonsurgical treatment avenues.
  • Previous studies suggest feasibility of CARTOSound-guided catheter radiofrequency ablation (RFA), but data remain scarce.
  • This study retrospectively assesses the effectiveness and safety of CARTOSound-guided RFA for HOCM patients.

Purpose of the Study:

  • To evaluate the efficacy of CARTOSound-guided catheter radiofrequency ablation (RFA) in managing hypertrophic obstructive cardiomyopathy (HOCM).
  • To assess the safety profile of CARTOSound-guided RFA in HOCM patients.
  • To determine the impact of RFA on left ventricular outflow tract (LVOT) obstruction and patient symptoms.

Main Methods:

  • Retrospective review of 37 HOCM patients with severe LVOT obstruction undergoing CARTOSound-guided RFA.
  • Integration of intracardiac echocardiography (ICE) with the CARTO system to create a left ventricular shell.
  • Targeting systolic anterior motion-septal contact areas identified by ICE for RFA delivery.
  • Analysis of follow-up data on LVOT gradient at various time points post-RFA.

Main Results:

  • Symptom improvement observed in 81.1% of patients (30/37), with NYHA class reduction.
  • Significant and sustained reduction in LVOT gradient achieved in 75.7% of patients (28/37).
  • Mean LVOT gradient decreased from 84.43 ± 27.55 mm Hg to 42.78 ± 36.38 mm Hg (P < .001).

Conclusions:

  • Catheter-mediated RFA guided by CARTOSound is an effective and safe treatment for HOCM.
  • RFA demonstrates significant symptom alleviation and reduction in LVOT obstruction.
  • Further validation through large-scale, multicenter clinical trials is recommended to confirm long-term efficacy and safety.
Abstract

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