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Objective <p>Percutaneous endocardial septal radiofrequency ablation (PESA) shows promise as a treatment for hypertrophic obstructive cardiomyopathy (HOCM). We aimed to explore the efficacy and safety of PESA require further study during a long-term follow-up.</p> Methods <p>We enrolled 25 patients HOCM who underwent PESA. The combination of a three-dimensional electrophysiological mapping system and intracardiac echocardiography (ICE) was employed to guide PESA. The patients were followed for 37 months (25–47.5 months), with transthoracic echocardiography performed 22 months (8–29 months) after the procedure.</p> Results <p>The mean age of patients was 55.3 ± 13.5 years (range: 23 to 79), and 11 (44%) of them were female. PESA led to a significant reduction in the left ventricular outflow tract gradient (LVOTG) from 79.0 ± 37.6 mmHg to 55.6 ± 34.8 mmHg (<i>p</i> = 0.002), as well as syncope episodes (60% vs. 19%, <i>p</i> = 0.0039) in patients with HOCM. The New York Heart Association (NYHA) functional class of the patients was improved from 2.14 ± 0.57 to 1.76 ± 0.54 (<i>p</i> = 0.002). In 10 patients undergoing cardiovascular magnetic resonance imaging (CMRI) both before PESA and at a follow-up of 3–6 months, the maximum left ventricular outflow tract velocity was ameliorated from 232.6 ± 56.8&#xa0;m/s to 159.4 ± 46.9&#xa0;m/s (<i>p</i> = 0.024). Besides, the minimum systolic diameter of left ventricular outflow tract was increased from 3.84 ± 2.6&#xa0;mm to 6.3 ± 2.3&#xa0;mm (<i>p</i> = 0.0006). There were no instances of cardiac tamponade, lethal arrhythmia, or death. Four patients underwent surgical septal myectomy during the follow-up.</p> Conclusions <p>PESA could attenuate LVOT obstruction and improve heart function in patients with HOCM during a long-term follow-up. PESA may be an effective and safe treatment for HOCM.</p>

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Percutaneous endocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy

  • 期刊论文

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  • 发表日期：

    2025年8月2日

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  • Aiju Tian,
  • Yunjiu Cheng,
  • Yuhe Jia,
  • Tianjing Zhang,
  • Jiaju Li,
  • Xuhua Chen,
  • Jun Liu,
  • Xiaogang Guo,
  • Qi Sun,
  • Min Tang,
  • Keping Chen,
  • Yan Yao

摘要

Objective

Percutaneous endocardial septal radiofrequency ablation (PESA) shows promise as a treatment for hypertrophic obstructive cardiomyopathy (HOCM). We aimed to explore the efficacy and safety of PESA require further study during a long-term follow-up.

Methods

We enrolled 25 patients HOCM who underwent PESA. The combination of a three-dimensional electrophysiological mapping system and intracardiac echocardiography (ICE) was employed to guide PESA. The patients were followed for 37 months (25–47.5 months), with transthoracic echocardiography performed 22 months (8–29 months) after the procedure.

Results

The mean age of patients was 55.3 ± 13.5 years (range: 23 to 79), and 11 (44%) of them were female. PESA led to a significant reduction in the left ventricular outflow tract gradient (LVOTG) from 79.0 ± 37.6 mmHg to 55.6 ± 34.8 mmHg (p = 0.002), as well as syncope episodes (60% vs. 19%, p = 0.0039) in patients with HOCM. The New York Heart Association (NYHA) functional class of the patients was improved from 2.14 ± 0.57 to 1.76 ± 0.54 (p = 0.002). In 10 patients undergoing cardiovascular magnetic resonance imaging (CMRI) both before PESA and at a follow-up of 3–6 months, the maximum left ventricular outflow tract velocity was ameliorated from 232.6 ± 56.8 m/s to 159.4 ± 46.9 m/s (p = 0.024). Besides, the minimum systolic diameter of left ventricular outflow tract was increased from 3.84 ± 2.6 mm to 6.3 ± 2.3 mm (p = 0.0006). There were no instances of cardiac tamponade, lethal arrhythmia, or death. Four patients underwent surgical septal myectomy during the follow-up.

Conclusions

PESA could attenuate LVOT obstruction and improve heart function in patients with HOCM during a long-term follow-up. PESA may be an effective and safe treatment for HOCM.