Catheter Ablation -> Ventricular Arrhythmias -> Experimental methods D-MP04 - New Horizons in Catheter Ablation (ID 22) Moderated ePoster

D-MP04-04 - Selective Ablation Of The Interventricular Septum In Hypertrophic Obstructive Cardiomyopathy (ID 850)

 H. Qiu: Nothing relevant to disclose.


Background: Septal reduction is needed for hypertrophic obstructive cardiomyopathy patients with severe left ventricular outflow tract gradients and symptoms despite medication. RF ablation has been published as a novel method to lighten LVOT obstruction. But so far, whether this procedure is suitable for all patients remained to be confirmed.
Objective: Analyze the features of patients that may influence the outcomes of ablation.
Methods: Twenty patients (mean age of 57.7 ±14.0, 27.3% male) with HOCM who underwent endocardial ablation were included. Intracardiac echocardiography images are merged with CARTO to create a shell of the cardiac chambers. Radiofrequency energy was delivered on the most hypertrophied septal region. ECG, echocardiography and cardiac MRI were evaluated before the procedure. Resting LVOT gradients were evaluated routinely at 1, 3 and 6 months follow - up after ablation.
Results: The resting LVOT gradient decreased from 87.1 ± 28.8 mm Hg to 48.4 ± 29.0 mm Hg (p < 0.001)after six months follow up. The IVS thickness decreased from 20.2 ± 6.4 mm Hg to 19.5 ± 6.6 mm Hg (p = 0.001). NYHA functional class improved from III [3.0 (2.0)] to II [2.0 (1.0)] (p < 0.001). The QRS duration increased from 97.4 ± 16.1 ms to 108.6 ± 17.2 (p < 0.05). The mean anterior mitral leaflet length (AML) was 27.9 ± 3.4 mm. The reduction of the LVOT gradient was various among patients. Patients presented little (<30%) reduction of LVOT gradient had longer AML length (30.28 ± 0.53 vs. 26.22 ± 0.83, p < 0.001)
Conclusion: Radiofrequency ablation is a safe and efficient procedure for selected HOCM patients to alleviate the LVOT gradient. For patients with prolonged MV , the efficacy of ERASH may be limited.