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Meta-Analysis
. 2020 May;43(5):450-458.
doi: 10.1002/clc.23341. Epub 2020 Feb 7.

Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta-analysis

Haonan Yang  1 , Yuan Yang  1 , Yuzhou Xue  1 , Suxin Luo  1
Affiliations
Meta-Analysis

Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta-analysis

Haonan Yang et al. Clin Cardiol. 2020 May.

Abstract

Background: Although radiofrequency ablation is widely used in the treatment of arrhythmias, its role in septal reduction therapy of hypertrophic obstructive cardiomyopathy (HOCM) is unclear. This meta-analysis aimed to assess the efficacy and safety of radiofrequency septal ablation for HOCM.

Hypothesis: Radiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM.

Methods: A systematic review of eligible studies that reported outcomes of patients with HOCM who underwent radiofrequency septal ablation was performed using PubMed, Embase, Cochrane, ProQuest, Scopus, ScienceDirect, and Web of Science database. Pooled estimates were calculated using random-effects meta-analysis. Methodological quality was assessed using the Newcastle-Ottawa scale. Publication bias and sensitivity analyses were also performed.

Results: Eight studies with 91 patients (mean follow-up 11.6 months) were included. The left ventricular outflow tract (LVOT) gradient at rest decreased significantly after radiofrequency septal ablation (pooled reduction: -58.8 mmHg; 95% confidence interval [CI] -64.3 to -53.5). A reduction was also found in the provoked LVOT gradient with a pooled reduction of -97.6 mmHg (95% CI: -124.4 to -87.1). An improvement of the New York Heart Association classification (mean: -1.4; 95% CI: -1.6 to -1.2) was found during follow-up. The change in septal thickness was minimal and not statistically significant. Two procedure-related deaths were documented, and complete heart block occurred in eight patients.

Conclusions: Radiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM.

Keywords: hypertrophic obstructive cardiomyopathy; meta-analysis; radiofrequency ablation; septal reduction therapy.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
Flow diagram of study selection process
Figure 2
Figure 2
Forest plots of the resting LVOT gradient, A, the provoked LVOT gradient, B, septal thickness, C, the NYHA class, D. For each estimate, the gray shaded area is the weight of the estimate in proportion to the overall effect. CI, confidence interval; LVOT, left ventricular outflow tract; NYHA, New York Heart Association; WMD, weighted mean difference
Figure 3
Figure 3
Begg's test funnel plot for the resting LVOT gradient. LVOT, left ventricular outflow tract
See this image and copyright information in PMC

References

    1. Elliott PM, Anastasakis A, Borger MA, et al. 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Europ Heart J. 2014;35(39):2733‐2779. - PubMed
    1. Liu Q, Li D, Berger AE, Johns RA, Gao L. Survival and prognostic factors in hypertrophic cardiomyopathy: a meta‐analysis. Sci Rep. 2017;7(1):11957. - PMC - PubMed
    1. Cooper RM, Raphael CE, Liebregts M, Anavekar NS, Veselka J. New developments in hypertrophic cardiomyopathy. Can J Cardiol. 2017;33(10):1254‐1265. - PubMed
    1. Maron BJ, Maron MS, Wigle ED, Braunwald E. The 50‐year history, controversy, and clinical implications of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy: from idiopathic hypertrophic subaortic stenosis to hypertrophic cardiomyopathy. J Am Coll Cardiol. 2009;54(3):191‐200. - PubMed
    1. Aksu T, Guler TE, Yalin K, et al. Role of endocardial septal ablation in the treatment of hypertrophic obstructive cardiomyopathy. Anatol J Cardiol. 2016;16(9):707‐712. - PMC - PubMed

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