Key result
Radiofrequency septal ablation linked to ~59% reduction in intraprocedural LVOT gradient from baseline in HOCM.
Why the study?
The study evaluated the correlation between interventricular septal diameter and procedural success, including immediate post-procedural gradient reduction, functional class improvement, and sustained gradient reduction at 6 months, in patients undergoing radiofrequency ablation for HOCM.
Does radiofrequency septal ablation improve intraventricular gradient and functional class in patients with hypertrophic obstructive cardiomyopathy?
Observational (n=22)
No
Does radiofrequency septal ablation improve intraventricular gradient and functional class in patients with hypertrophic obstructive cardiomyopathy?
Effect estimate: Relative reduction 58.9% (95% CI 51.1-66.7)
Absolute Event Rate: 34.1% vs 78.2%
p-value: p=<0.001
Radiofrequency septal ablation is an effective invasive management strategy for HOCM, yielding significant gradient reduction and functional improvement, particularly in patients with thicker septa.
May support acute gradient relief in select HOCM patients; leaves open long-term efficacy versus established therapies.
Background: Hypertrophic obstructive cardiomyopathy (HOCM) is an autosomal dominant genetic disorder.Invasive treatment for intraventricular gradient reduction is indicated in patients (p) who are refractory to clinical treatment with gradient 50 mmHg.Radiofrequency ablation (RFA) is one of the current options for invasive management.Objectives: To evaluate the correlation between interventricular septal diameter and procedural success, defined as immediate post-procedural gradient reduction, improvement in functional class (FC), and sustained gradient reduction at 6-month follow-up.Methods: Twenty-two patients with HOCM were included.Transthoracic echocardiography was performed before and six months after RFA, while transesophageal echocardiography (TEE) was carried out intraprocedure.Results: The mean age was 56.64 years ( 12.23), with 68.18% of patients being female and 73% hypertensive.An immediate gradient reduction greater than 50% was observed in 72.7% of patients.At the 6-month follow-up, 60% of patients showed a 50% gradient reduction along with an improvement in FC.A median septal thickness of 18 mm was associated with greater procedural success compared to a median of 15 mm, and no significant change in septal thickness was observed over the 6-month follow-up period. Conclusion:Radiofrequency septal ablation (RFSA) is an effective and safe technique for the invasive management of HOCM.The procedure enables a significant reduction in the intraventricular gradient, accompanied by improved FC and sustained short-term results.Thicker septal were associated with greater intraprocedural gradient reductions; however, there was no reduction in thickness during the 6-month follow-up.
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Vilela et al. (2025) conducted an observational in Hypertrophic obstructive cardiomyopathy (n=22). Radiofrequency septal ablation vs. Pre-procedure baseline was evaluated on Intraprocedural left ventricular outflow tract gradient (mmHg) (Relative reduction 58.9%, 95% CI 51.1-66.7, p=<0.001). Radiofrequency septal ablation significantly reduced the intraprocedural left ventricular outflow tract gradient by 58.9% compared to baseline in patients with hypertrophic obstructive cardiomyopathy.
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