Two-Year Results of Percutaneous Endocardial Septal Radiofrequency Ablation for Hypertrophic Obstructive...

Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary myocardial disease. Percutaneous endocardial septal radiofrequency ablation (PESA) is an innovative approach for treating HOCM. Consequently, we present the outcomes of the PESA for HOCM.

This study included 20 patients with HOCM who received PESA. The primary outcomes include the control rate of the left ventricular outflow tract gradient (LVOTG) at rest and following the Valsalva maneuver and changes in New York Heart Association (NYHA) function. Secondary outcomes include changes in interventricular septal thickness (IVST), left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP). In addition, this study assessed the incidence of complications during the perioperative period, the operation time of the PESA, and hospital stays.

After 2 years, the LVOTG for patients decreased 54% at rest and 55% after the Valsalva maneuver. In addition, the NYHA functional index increased from 3.25 ± 0.55 to 1.95 ± 0.88, and 15 patients (75%) achieved NYHA Class I/Ⅱ. The LVEF of patients significantly increased from 63.95 ± 6.29% to 65.75 ± 3.39%, the PASP decreased from 32.50 (31.00, 40.50) mmHg to 23.50 (19.50, 28.50) mmHg, the NT-proBNP decreased from 388.90 (278.80, 1039.00) ng/mL to 227.4 (121.6, 499.6) ng/mL, and the IVST decreased from 17.20 ± 3.72 mm to 15.80 ± 3.14 mm. Importantly, no patients needed pacemaker treatment. The operative time for the PESA was 186.63 ± 22.47 min, and the median postoperative hospital stay for patients was 10.00 days.

PESA could reduce the LVOTG with the advantages of a low risk of arrhythmias, minimal trauma, rapid postoperative recovery, and shorter hospital stays.