Radiofrequency ablation in patients with obstructive hypertrophic cardiomyopathy: An updated comprehensive review and meta‐analysis

Author:

da Silva Menezes Antonio12ORCID,Sanches Murilo R.1,de Oliveira Filho Ernani1,de Oliveira Elias J. R.1,Oliveira Vinicius M. R.1,Moraes Vitor R. Y.3

Affiliation:

1. Internal Medicine Department, Medicine Faculty Federal University of Goiás Goiás Brazil

2. Clinical Medicine Department, Medical and Life School Pontifical Catholic University of Goiás Goiás Brazil

3. Clinical Medicine Department, Medical School Evangelical University of Goiás Goiás Brazil

Abstract

AbstractBackgroundRadiofrequency catheter ablation (RFCA) has emerged as a therapeutic option for surgical myectomy and alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM), but its efficacy remains unclear.AimDue to limited research on RFCA for HCM, there is an ongoing attempt to assess its efficacy and safety.MethodsPubMed, Embase, and Scopus were systematically searched for studies assessing the efficacy outcomes for patients with HOCM who underwent RFCA. Mean differences (MDs) with 95% confidence intervals (CIs) were computed using a random‐effects model and heterogeneity was assessed using I2 statistics.ResultsWe included 11 studies comprising 470 patients, of whom 34.6% were female. The mean patient age ranged from 43.7 to 60.7 years. During the follow‐up after RFCA, there was a significant decrease in the left ventricular outflow tract (LVOT) gradient at rest (MD −60.25 mmHg; 95% CI [−70.53;−59.14 mmHg]; p < 0.01) and during stimulation (MD −83.56 mmHg; 95% CI [−100.36;−66.76 mmHg]; p < 0.01). Moreover, RFCA reduced interventricular septum (IVS) thickness (MD −3.61 mm; 95% CI [−5.64; −1.59 mm]; p = 0.01) and New York Heart Association (NYHA) class (MD −1.46; 95% CI [−1.69; −1.24]; p < 0.01).ConclusionsIn patients with HOCM, RFCA was associated with an improved NYHA class, reduced IVS thickness, and decreased LVOT gradient at rest and with stimulation.

Publisher

Wiley

Reference31 articles.

1. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guideline;Ommen SR;Circulation,2020

2. New Perspectives on the Prevalence of Hypertrophic Cardiomyopathy

3. Effect of Left Ventricular Outflow Tract Obstruction on Clinical Outcome in Hypertrophic Cardiomyopathy

4. Hypertrophic Obstructive Cardiomyopathy

5. Exploring New and Old Therapies for Obstructive Hypertrophic Cardiomyopathy

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