Key result
Invasive HOCM treatments require careful patient selection to optimize clinical outcomes.
Why the study?
HOCM produces dismal long-term outcomes if left untreated, requiring a review of standard invasive treatments, novel techniques, guidelines, and management of complex presentations.
This review provides a comprehensive analysis of standard and novel invasive treatments for HOCM, highlighting the critical role of tailored patient selection.
Requires careful HOCM patient selection now; leaves open prospective validation of criteria.
BACKGROUND: Hypertrophic obstructive cardiomyopathy (HOCM) is a heterogeneous disease with different clinical presentations, albeit producing similar dismal long-term outcomes if left untreated. Several approaches are available for the treatment of HOCM; e.g., alcohol septal ablation (ASA) and surgical myectomy (SM). The objectives of the current review were to (1) discuss the place of the standard invasive treatment modalities (ASA and SM) for HOCM; (2) summarize and compare novel techniques for the management of HOCM; (3) analyze current guidelines addressing HOCM management; and (4) offer suggestions for the treatment of complex HOCM presentations. METHODS: We searched the literature and attempted to gather the most relevant and impactful available evidence on ASA, SM, and other invasive means of treatment of HOCM. The literature search yielded thousands of results, and 103 significant publications were ultimately included. RESULTS: We critically analyzed available guidelines and provided context in the setting of patient selection for standard and novel treatment modalities. This review offers the most comprehensive analysis to-date of available invasive treatments for HOCM. These include the standard treatments, SM and ASA, as well as novel treatments such as dual-chamber pacing and radiofrequency catheter ablation. We also account for complex pathoanatomic presentations and current guidelines to offer suggestions for tailored care of patients with HOCM. Finally, we consider promising future therapies for HOCM. CONCLUSIONS: HOCM is a heterogeneous disease associated with poor outcomes if left untreated. Several strategies for treatment of HOCM are available but patient selection for the procedure is crucial.
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Lebowitz et al. (2022) conducted a review in Hypertrophic obstructive cardiomyopathy (HOCM). Invasive treatment approaches (alcohol septal ablation, surgical myectomy, novel techniques) was evaluated. A state-of-the-art review of 103 publications on invasive treatments for hypertrophic obstructive cardiomyopathy emphasizes that careful patient selection is crucial for optimizing clinical outcomes.
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