Key result
Septal myectomy resulted in a greater reduction of resting left ventricular outflow tract gradient (SMD -3.03) compared to endocardial radiofrequency ablation (SMD -1.95) in adults with hypertrophic obstructive cardiomyopathy.
Why the study?
Septal myectomy is the gold standard for hypertrophic obstructive cardiomyopathy, but the relative efficacy and safety of novel endocardial radiofrequency ablation of septal hypertrophy remained to be assessed.
Does endocardial radiofrequency ablation of septal hypertrophy improve resting LVOTG and septal thickness compared to septal myectomy in patients with hypertrophic obstructive cardiomyopathy?
Meta-Analysis (n=2,580)
Does endocardial radiofrequency ablation of septal hypertrophy improve resting LVOTG and septal thickness compared to septal myectomy in patients with hypertrophic obstructive cardiomyopathy?
Standardized Mean Difference: -3.03 (95% CI -3.62–-2.44)
Septal myectomy provides superior reduction in LVOT gradient and septal thickness compared to endocardial radiofrequency ablation, though ERASH may be a less invasive alternative for high-risk patients.
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SM preferred for most HOCM patients; observational meta-analysis leaves open ERASH role in high-surgical-risk cases.
Jiang et al. (2022) conducted a meta-analysis in Hypertrophic obstructive cardiomyopathy (n=2,580). Septal myectomy vs. Endocardial radiofrequency ablation of septal hypertrophy was evaluated on Reduction in resting left ventricular outflow tract gradient (LVOTG) in adults (SMD -3.03, 95% CI -3.62 to -2.44). Septal myectomy resulted in a greater reduction of resting left ventricular outflow tract gradient (SMD -3.03) compared to endocardial radiofrequency ablation (SMD -1.95) in adults with hypertrophic obstructive cardiomyopathy.
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