Abstract
BackgroundAlthough radiofrequency ablation is widely used in the treatment of arrhythmias, its role in septal reduction therapy of hypertrophic obstructive cardiomyopathy (HOCM) is unclear. This meta‐analysis aimed to assess the efficacy and safety of radiofrequency septal ablation for HOCM.HypothesisRadiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM.MethodsA systematic review of eligible studies that reported outcomes of patients with HOCM who underwent radiofrequency septal ablation was performed using PubMed, Embase, Cochrane, ProQuest, Scopus, ScienceDirect, and Web of Science database. Pooled estimates were calculated using random‐effects meta‐analysis. Methodological quality was assessed using the Newcastle‐Ottawa scale. Publication bias and sensitivity analyses were also performed.ResultsEight studies with 91 patients (mean follow‐up 11.6 months) were included. The left ventricular outflow tract (LVOT) gradient at rest decreased significantly after radiofrequency septal ablation (pooled reduction: −58.8 mmHg; 95% confidence interval [CI] −64.3 to −53.5). A reduction was also found in the provoked LVOT gradient with a pooled reduction of −97.6 mmHg (95% CI: −124.4 to −87.1). An improvement of the New York Heart Association classification (mean: −1.4; 95% CI: −1.6 to −1.2) was found during follow‐up. The change in septal thickness was minimal and not statistically significant. Two procedure‐related deaths were documented, and complete heart block occurred in eight patients.ConclusionsRadiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM.
Highlights
Hypertrophic obstructive cardiomyopathy (HOCM) could lead to symptoms of dyspnea, chest pain, and syncope due to left ventricular outflow tract (LVOT) obstruction
The use of alcohol septal ablation (ASA) is limited by coronary anatomy, which means that 5% to15% of patients are unsuitable to undergo ASA.[7,8]
The benefits of radiofrequency ablation have been widely accepted in the treatment of cardiac arrhythmias, such as ventricular tachycardia and atrial fibrillation, it is still a novel technique in patients with hypertrophic obstructive cardiomyopathy (HOCM)
Summary
Hypertrophic obstructive cardiomyopathy (HOCM) could lead to symptoms of dyspnea, chest pain, and syncope due to left ventricular outflow tract (LVOT) obstruction. Alcohol septal ablation (ASA) has been an appealing alternative approach in the treatment of HOCM because it effectively reduced symptoms with less trauma and shorter hospital stay than myectomy. Radiofrequency catheter ablation has been a well-accepted treatment of cardiac arrhythmia for many decades. This technique has been used to relieve LVOT obstruction without restriction of the coronary anatomy.[9]. The efficacy and safety of radiofrequency septal ablation have not been clear, as only small studies on this topic were conducted. In the current study, we aimed to perform a systematic review and meta-analysis of the short-term efficacy and safety of radiofrequency ablation for HOCM
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
