Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients With Drug-Refractory Hypertrophic Obstructive Cardiomyopathy

作者：Mengyao Zhou, Shengjun Ta, Rebecca T. Hahn, David H. Hsi, Martin B. Leon, Rui Hu, Jun Zhang, Lei Zuo, Jing Li, Jing Wang, Bo Wang, Xiaoli Zhu, Jiani Liu, Yupeng Han, Xiaojuan Li, Bo Xu, Lei Zhang, Lihong Hou, Chao Han, Jincheng Liu, Liwen Liu · 发表于：JAMA Cardiology · 年份：2022 · DOI：10.1001/jamacardio.2022.0259 · 被引用次数：100 · 研究领域：Cardiomyopathy and Myosin Studies、Cardiac Arrhythmias and Treatments、Cardiovascular Function and Risk Factors

Importance: Patients with hypertrophic obstructive cardiomyopathy (HOCM) and drug-refractory symptoms and outflow gradients have limited nonsurgical treatment options. The feasibility of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) has been reported previously; however, procedural and medium-term outcomes are unknown. Objective: To describe the safety and medium-term outcomes of PIMSRA in a large patient cohort with drug-refractory HOCM. Design, Setting, and Participants: This was a single-arm, open-label study of PIMSRA in patients with drug-refractory HOCM. Patients presenting to the Xijing Hospital in Xi'an, China, between October 2016 to June 2020 with hypertrophic cardiomyopathy. Of 1314 patients presenting with HOCM, 244 fulfilled inclusion criteria of severe resting/provoked outflow gradients of 50 mm Hg or higher, and symptoms of New York Heart Association functional class of II or higher refractory to maximum tolerated medications. After discussion among the heart team, 40 patients underwent surgical or alcohol septal reduction therapy and 4 required treatment of significant coronary artery disease. Interventions: PIMSRA performed in patients. Main Outcomes and Measures: The primary outcome was 30-day major adverse clinical events: death, emergency surgery, severe effusion requiring intervention, procedure-related stroke, bleeding, and stroke. Secondary outcomes included 30-day technical success and 90-day improvement in outflow obstruction. R...