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Percutaneous endocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy

Aiju Tian1, Yunjiu Cheng2, Yuhe Jia3

  • 1Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

BMC Cardiovascular Disorders
|August 2, 2025
PubMed

Insights

Percutaneous endocardial septal radiofrequency ablation (PESA) significantly reduces left ventricular outflow tract obstruction and improves heart function in hypertrophic obstructive cardiomyopathy (HOCM) patients. This study confirms PESA as a safe and effective long-term treatment option.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by left ventricular outflow tract obstruction (LVOTO).
  • Percutaneous endocardial septal radiofrequency ablation (PESA) is an emerging therapeutic approach for HOCM.

Purpose of the Study:

  • To evaluate the long-term efficacy and safety of PESA in patients with HOCM.
  • To assess the impact of PESA on left ventricular outflow tract gradient (LVOTG), symptoms, and cardiac function.

Main Methods:

  • Twenty-five HOCM patients underwent PESA guided by 3D electrophysiological mapping and intracardiac echocardiography (ICE).
  • Patients were followed for a median of 37 months, with echocardiography performed post-procedure.
  • Cardiovascular magnetic resonance imaging (CMRI) was used in a subset of patients to assess LVOT parameters.

Main Results:

  • PESA significantly reduced LVOT gradient (79.0 to 55.6 mmHg, p=0.002) and syncope episodes (60% to 19%, p=0.0039).
  • New York Heart Association (NYHA) functional class improved (2.14 to 1.76, p=0.002).
  • CMRI showed reduced LVOT velocity and increased LVOT diameter post-PESA, with no major adverse events reported.

Conclusions:

  • PESA effectively attenuates LVOT obstruction and improves cardiac function in HOCM patients.
  • The procedure demonstrates a favorable safety profile with significant long-term benefits.
  • PESA represents a viable and safe therapeutic option for managing HOCM.
Abstract

Keywords:
Cardiovascular magnetic resonance imagingHeart functionHypertrophic obstructive cardiomyopathySeptal radiofrequency ablation

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