Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit?
Introduction: Septal mass reduction is beneficial for hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow (LVOT) gradient and symptoms, with surgical myectomy or alcohol septal ablation (ASA) currently recommended in selected patients. Radiofrequency (RF) abl...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:59afec25611f44e2a9f56e0e124a4b012021-11-16T05:21:03ZSelective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit?2297-055X10.3389/fcvm.2021.743044https://doaj.org/article/59afec25611f44e2a9f56e0e124a4b012021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.743044/fullhttps://doaj.org/toc/2297-055XIntroduction: Septal mass reduction is beneficial for hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow (LVOT) gradient and symptoms, with surgical myectomy or alcohol septal ablation (ASA) currently recommended in selected patients. Radiofrequency (RF) ablation of hypertrophied septum has been published as a novel method to alleviate LVOT obstruction in small populations. This study aims to investigate factors influencing clinical outcomes of radiofrequency septum ablation.Methods and Results: In this study, 20 patients with HOCM who underwent endocardial ablation were included. Echocardiography and cardiac MRI (CMR) data was collected and analyzed pre- and (or) post- procedure. Nineteen patients underwent ablation successfully, while ablation was aborted in one patient with prior RBBB due to transient complete atrioventricular block (AVB). After 6 months of follow-up, NYHA heart functional class improved from III (2 - 3) to II (1 - 2) (p < 0.001), and resting LVOT gradient was significantly reduced (87.6 ± 29.5 mmHg vs. 48.1 ± 29.7, p < 0.001). LVOT gradient reduction was significantly higher in patients with limited basal septal hypertrophy (60.9 ± 8.3 vs. 27.9 ± 7.1, p = 0.01), shorter anterior mitral leaflet (56.1 ± 6.4 vs. 20.4 ± 5.0, p < 0.01), and normally positioned papillary muscle (36.9 ± 7.1 vs. 75.0 ± 6.3, p < 0.05).Conclusions: Endocardial septal ablation appears to be a safe and effective procedure for alleviating LVOT gradient in patients with HOCM, especially in those with limited basal septal hypertrophy, shorter anterior mitral leaflet, and normal positioned papillary muscle.Qiang LiuHangyuan QiuRuhong JiangXiaomei TangWenpu GuoKuangshi ZhouQiufan ChenYaxun SunLu YuShiquan ChenPei ZhangXia ShengJun ZhuJianwei LinHui ChengYunhe WangBei WangChan YuYankai MaoJuhong ZhangZuwen ZhangPaul C. ZeiGuosheng FuChenyang JiangFrontiers Media S.A.articlehypertrophic obstructive cardiomyopathyradiofrequency septal ablationanterior mitral leafletpapillary muscle displacementmid-septal hypertrophyDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
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| collection |
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EN |
| topic |
hypertrophic obstructive cardiomyopathy radiofrequency septal ablation anterior mitral leaflet papillary muscle displacement mid-septal hypertrophy Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
hypertrophic obstructive cardiomyopathy radiofrequency septal ablation anterior mitral leaflet papillary muscle displacement mid-septal hypertrophy Diseases of the circulatory (Cardiovascular) system RC666-701 Qiang Liu Hangyuan Qiu Ruhong Jiang Xiaomei Tang Wenpu Guo Kuangshi Zhou Qiufan Chen Yaxun Sun Lu Yu Shiquan Chen Pei Zhang Xia Sheng Jun Zhu Jianwei Lin Hui Cheng Yunhe Wang Bei Wang Chan Yu Yankai Mao Juhong Zhang Zuwen Zhang Paul C. Zei Guosheng Fu Chenyang Jiang Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit? |
| description |
Introduction: Septal mass reduction is beneficial for hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow (LVOT) gradient and symptoms, with surgical myectomy or alcohol septal ablation (ASA) currently recommended in selected patients. Radiofrequency (RF) ablation of hypertrophied septum has been published as a novel method to alleviate LVOT obstruction in small populations. This study aims to investigate factors influencing clinical outcomes of radiofrequency septum ablation.Methods and Results: In this study, 20 patients with HOCM who underwent endocardial ablation were included. Echocardiography and cardiac MRI (CMR) data was collected and analyzed pre- and (or) post- procedure. Nineteen patients underwent ablation successfully, while ablation was aborted in one patient with prior RBBB due to transient complete atrioventricular block (AVB). After 6 months of follow-up, NYHA heart functional class improved from III (2 - 3) to II (1 - 2) (p < 0.001), and resting LVOT gradient was significantly reduced (87.6 ± 29.5 mmHg vs. 48.1 ± 29.7, p < 0.001). LVOT gradient reduction was significantly higher in patients with limited basal septal hypertrophy (60.9 ± 8.3 vs. 27.9 ± 7.1, p = 0.01), shorter anterior mitral leaflet (56.1 ± 6.4 vs. 20.4 ± 5.0, p < 0.01), and normally positioned papillary muscle (36.9 ± 7.1 vs. 75.0 ± 6.3, p < 0.05).Conclusions: Endocardial septal ablation appears to be a safe and effective procedure for alleviating LVOT gradient in patients with HOCM, especially in those with limited basal septal hypertrophy, shorter anterior mitral leaflet, and normal positioned papillary muscle. |
| format |
article |
| author |
Qiang Liu Hangyuan Qiu Ruhong Jiang Xiaomei Tang Wenpu Guo Kuangshi Zhou Qiufan Chen Yaxun Sun Lu Yu Shiquan Chen Pei Zhang Xia Sheng Jun Zhu Jianwei Lin Hui Cheng Yunhe Wang Bei Wang Chan Yu Yankai Mao Juhong Zhang Zuwen Zhang Paul C. Zei Guosheng Fu Chenyang Jiang |
| author_facet |
Qiang Liu Hangyuan Qiu Ruhong Jiang Xiaomei Tang Wenpu Guo Kuangshi Zhou Qiufan Chen Yaxun Sun Lu Yu Shiquan Chen Pei Zhang Xia Sheng Jun Zhu Jianwei Lin Hui Cheng Yunhe Wang Bei Wang Chan Yu Yankai Mao Juhong Zhang Zuwen Zhang Paul C. Zei Guosheng Fu Chenyang Jiang |
| author_sort |
Qiang Liu |
| title |
Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit? |
| title_short |
Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit? |
| title_full |
Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit? |
| title_fullStr |
Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit? |
| title_full_unstemmed |
Selective Interventricular Septal Radiofrequency Ablation in Patients With Hypertrophic Obstructive Cardiomyopathy: Who Can Benefit? |
| title_sort |
selective interventricular septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy: who can benefit? |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/59afec25611f44e2a9f56e0e124a4b01 |
| work_keys_str_mv |
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