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Original research
Percutaneous intramyocardial septal radiofrequency ablation after 5-year follow-up
  1. Shengjun Ta1,
  2. Jing Li1,
  3. David H Hsi2,
  4. Rui Hu1,
  5. Changhui Lei1,
  6. Bo Shan1,
  7. Wenxia Li1,
  8. Jing Wang1,
  9. Bo Wang1,
  10. Nan Kang1,
  11. Xiaojuan Li1,
  12. Jiani Liu1,
  13. Caixia Qi1,
  14. Junzhe Huang1,
  15. Yupeng Han1,
  16. Fangqi Ruan1,
  17. Jun Zhang1,
  18. Liwen Liu1
  1. 1 Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
  2. 2 Heart & Vascular Institute, Stamford Hospital, CT and Columbia University College of Physicians & Surgeons, New York, New York, USA
  1. Correspondence to Dr Liwen Liu, Department of Ultrasound, Xijing Hospital, Xi'an, Shaanxi 710032, China; liuliwen{at}fmmu.edu.cn

Abstract

Objective The objective is to evaluate the 5-year follow-up results of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) for hypertrophic obstructive cardiomyopathy (HOCM), including clinical status, electrocardiographic and echocardiographic characteristics.

Methods 27 patients (age: 44.3±15.5 years; 67% men, 33% women) with severely symptomatic HOCM who underwent PIMSRA from October 2016 to September 2017 were included. Their clinical status, resting and exercise stress echocardiography, electrocardiography and cardiac MRI (CMRI) after long-term follow-up were assessed.

Results One patient died of intracerebral haemorrhage 1 year post procedurally. The New York Heart Association class, Canadian Cardiovascular Society class and exercise-induced syncopal attacks improved significantly in 26 patients (all p<0.01). Left ventricular (LV) outflow tract gradients revealed sustained reduction (resting: from 95.0 to 9.0 mm Hg, p<0.001; post exercise: from 130.5 to 21.0 mm Hg, p<0.001). The echocardiographic evaluation revealed decreased septal thickness, LV posterior wall thickness and left atrial (LA) diameter (all p<0.001). CMRI data revealed decrease in LV mass index and LA volume index and increase in LV end-diastolic volume index and stroke volume index between baseline and long-term follow-up (all p<0.05). The global longitudinal strain of LV improved from (−11.9%±3.7%) before the procedure to (−13.1%±3.9%) at the last check (p<0.001). Malignant ventricular arrhythmia and heart failure events were not observed.

Conclusions PIMSRA can effectively alleviate symptoms in patients with HOCM and improve their hemodynamics in the long term.

Trial registration number NCT02888132.

  • Cardiomyopathy, Hypertrophic
  • Echocardiography

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors ST, JLi and DHH equally contributed to this work. LL designed and guaranteed the study. LL, JLi, RH, CL, WL and JLiu performed the procedure. ST, BS, WL, JW, BW, NK, XL, CQ, JH, YH and FR performed data collection, analysis and interpretation. LL and JZ performed editing and final review. All authors read and approved the final manuscript. Dr Liu is the guarantor of this work and, as such, has all access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This study was supported by the National Natural Science Foundation of China (grant numbers 82071932 and 82001831) and Clinical Research Funding Project of Fourth Military Medical University (grant number 2021XD010).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.