Radiofrequency ablation in patients with obstructive hypertrophic cardiomyopathy: An updated comprehensive review and meta‐analysis

Abstract Background Radiofrequency catheter ablation (RFCA) has emerged as a therapeutic option for surgical myectomy and alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM), but its efficacy remains unclear. Aim Due to limited research on RFCA for HCM, ther...

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Published in:Catheterization and cardiovascular interventions 2024-06
Main Authors: da Silva Menezes, Antonio, Sanches, Murilo R., de Oliveira Filho, Ernani, de Oliveira, Elias J. R., Oliveira, Vinicius M. R., Moraes, Vitor R. Y.
Format: Article
Language:English
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Summary:Abstract Background Radiofrequency catheter ablation (RFCA) has emerged as a therapeutic option for surgical myectomy and alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM), but its efficacy remains unclear. Aim Due to limited research on RFCA for HCM, there is an ongoing attempt to assess its efficacy and safety. Methods PubMed, Embase, and Scopus were systematically searched for studies assessing the efficacy outcomes for patients with HOCM who underwent RFCA. Mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random‐effects model and heterogeneity was assessed using I 2 statistics. Results We included 11 studies comprising 470 patients, of whom 34.6% were female. The mean patient age ranged from 43.7 to 60.7 years. During the follow‐up after RFCA, there was a significant decrease in the left ventricular outflow tract (LVOT) gradient at rest (MD −60.25 mmHg; 95% CI [−70.53;−59.14 mmHg]; p < 0.01) and during stimulation (MD −83.56 mmHg; 95% CI [−100.36;−66.76 mmHg]; p < 0.01). Moreover, RFCA reduced interventricular septum (IVS) thickness (MD −3.61 mm; 95% CI [−5.64; −1.59 mm]; p = 0.01) and New York Heart Association (NYHA) class (MD −1.46; 95% CI [−1.69; −1.24]; p < 0.01). Conclusions In patients with HOCM, RFCA was associated with an improved NYHA class, reduced IVS thickness, and decreased LVOT gradient at rest and with stimulation.
ISSN:1522-1946
1522-726X
1522-726X
DOI:10.1002/ccd.31125