Key result
Endocardial septal pulsed field ablation achieves ~45% LVOTG reduction in a single HOCM patient.
Why the study?
Does percutaneous endocardial septal pulsed field ablation reduce left ventricular outflow tract gradients in a patient with hypertrophic obstructive cardiomyopathy?
Case Report (n=1)
Does percutaneous endocardial septal pulsed field ablation reduce left ventricular outflow tract gradients in a patient with hypertrophic obstructive cardiomyopathy?
Percutaneous endocardial septal pulsed field ablation may be a feasible novel approach for reducing outflow tract gradients in hypertrophic obstructive cardiomyopathy.
A 53-year-old man was diagnosed with hypertrophic obstructive cardiomyopathy (HOCM). Transthoracic echocardiography (TTE) demonstrated a basal interventricular septal thickness of 13.7 mm and a left ventricular outflow tract gradient (LVOTG) of 73 mmHg. Under intracardiac echocardiography and three-dimensional electroanatomical mapping system guidance, the patient underwent percutaneous endocardial septal pulsed field ablation (PES-PFA). Clinical improvement was achieved. Invasive assessment showed the transaortic pressure gradient decreased from 59 to 32 mmHg. At 1-month follow-up, TTE confirmed LVOTG reduction to 40 mmHg. This case highlights PES-PFA as a novel approach for HOCM, though further investigation is warranted to establish its safety and efficacy.
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Tian et al. (2025) conducted a case report in Hypertrophic obstructive cardiomyopathy (HOCM) (n=1). Percutaneous endocardial septal pulsed field ablation (PES-PFA) was evaluated on Left ventricular outflow tract gradient (LVOTG). Percutaneous endocardial septal pulsed field ablation reduced the left ventricular outflow tract gradient from 73 to 40 mmHg at 1-month follow-up in a patient with HOCM.
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