We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Acute and chronic effects of endocardial radiofrequency ablation of septal hypertrophy in HOCM.
- Authors
Lawrenz, Thorsten; Lawin, Dennis; Radke, Kristin; Stellbrink, Christoph
- Abstract
Introduction: Endocardial radiofrequency ablation of septal hypertrophy (ERASH) is an alternative to alcohol septal ablation (ASA) or surgical myectomy for hypertrophic obstructive cardiomyopathy (HOCM). Several studies have confirmed that septal radiofrequency ablation leads to a significant reduction in the left ventricular outflow tract gradient. Objectives: We aimed to report the outcomes of 41 patients who underwent ERASH with a focus on severe complications. Methods: Since 2004, 41 patients with HOCM (age: 58.2 ± 13 years) underwent ERASH at our institution. ERASH was performed, since ASA was ineffective (26 patients) or not possible (15 patients). Results: The left ventricular outflow tract and the right ventricular septum were ablated in 26 and 15 patients, respectively. ERASH resulted in a significant reduction in acute gradient during the session and the results persisted during the 6‐month follow‐up (67% gradient reduction at rest and 73% after provocation, p =.0002). Pacemaker dependency after ERASH was 29% and pericardial tamponade occurred in two patients. In four patients, ERASH induced a paradoxical increase in obstruction (PIO), beginning suddenly at 30 min after the procedure and leading to lethal shock in one patient. PIO was not observed after ERASH from the right ventricular aspect. Conclusion: Morbidity and mortality after ERASH were higher than those after ASA. PIO, a life‐threatening complication, was observed in 9% of the patients. Our data indicate that ERASH might be considered in patients who are not candidates for surgical myectomy or ASA.
- Subjects
GERMANY; CARDIAC hypertrophy; MORTALITY; CATHETER ablation; HEART septum; SURGICAL complications; DISEASES; TREATMENT effectiveness; CARDIAC tamponade; VENTRICULAR outflow obstruction; DESCRIPTIVE statistics; CARDIAC pacemakers; ABLATION techniques
- Publication
Journal of Cardiovascular Electrophysiology, 2021, Vol 32, Issue 10, p2617
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.15203