Radiofrequency Ablation of the Interventricular Septum to Treat Outflow Tract Gradients in Hocm: Novel Use of Cartosound Technology to Guide Ablation

Cooper, Robert; Modi, Suneel Simon; Shahzad, Adeel; Hasleton, Jonathan; DeGiovanni, Joseph V.; Hall, Mark; Todd, Derick; Stables, Rod

doi:10.1016/s0735-1097(15)60950-0

Cited by 1 publication

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“…Pooled analysis of four studies that reported the provoked LVOT gradient of participants showed a 97.6‐mmHg reduction ( P < .01) after the procedure with moderate between‐study heterogeneity. Sensitivity analysis showed a reduction in heterogeneity when the study conducted by Cooper et al was excluded. Thus, another pooled analysis containing three studies (Figure ) was conducted and showed a reduction in the provoked LVOT gradient of 105.7 mmHg ( P < .01) after radiofrequency ablation.…”

Section: Resultsmentioning

confidence: 99%

“…After removing duplicates, 1624 studies remained. Eight studies published between 2005 and 2019 (including a conference abstract) were included in this analysis according to the inclusion and exclusion criteria (Figure ). Ninety‐one patients underwent radiofrequency septal ablation for HOCM with a mean follow‐up of 11.6 months (range, 1.3‐48 months).…”

Section: Resultsmentioning

confidence: 99%

“…All studies were assessed by NOS in which two studies received seven scores, four studies received eight scores and two studies received nine scores. It represented moderate to high methodological quality.…”

Section: Resultsmentioning

confidence: 99%

“…With the electroanatomical mapping system, the advantage of radiofrequency septal ablation was accuracy in targeting the SAM‐septal contact area, independent of the coronary anatomy. Studies proved that a small amount of damage accurately delivered through radiofrequency ablation did interrupt the SAM‐septal feedback mechanism and reduced the LVOT gradient as effectively as ASA, with a minimal change in septal thickness.…”

Section: Discussionmentioning

confidence: 99%

“…In this review, we found that the incidence of permanent pacemaker implantation was 8.8%, which was not higher than that of ASA. However, clinical studies of radiofrequency ablation conducted in recent years reported a lower incidence of pacemaker dependency because of use of the electroanatomical mapping system . The His conduction tissue, left bundle, and left anterior and posterior fascicles were directly mapped during radiofrequency ablation, which helped to preserve atrioventricular conduction and was a potential benefit of radiofrequency ablation.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta‐analysis

Yang

Xue

et al. 2020

Clinical Cardiology

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Background: Although 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.Hypothesis: Radiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM.Methods: A 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.Results: Eight 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.Conclusions: Radiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM. K E Y W O R D S hypertrophic obstructive cardiomyopathy, meta-analysis, radiofrequency ablation, septal reduction therapy Haonan Yang and Yuan Yang contributed equally to this work.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%