Internal Medicine Department, Medicine Faculty, Federal University of Goiás, Goiás, Brazil.
Clinical Medicine Department, Medical and Life School, Pontifical Catholic University of Goiás, Goiás, Brazil.
Catheter Cardiovasc Interv. 2024 Nov;104(5):1096-1106. doi: 10.1002/ccd.31125. Epub 2024 Jun 21.
Radiofrequency 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.
Due to limited research on RFCA for HCM, there is an ongoing attempt to assess its efficacy and safety.
PubMed, 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 I statistics.
We 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).
In patients with HOCM, RFCA was associated with an improved NYHA class, reduced IVS thickness, and decreased LVOT gradient at rest and with stimulation.
射频导管消融（RFCA）已成为肥厚型梗阻性心肌病（HOCM）患者手术心肌切除术和酒精室间隔消融（ASA）的治疗选择，但疗效仍不清楚。
由于对 HCM 的 RFCA 研究有限，目前正在尝试评估其疗效和安全性。
系统检索了评估接受 RFCA 的 HOCM 患者疗效结局的研究，检索了 PubMed、Embase 和 Scopus。使用随机效应模型计算均值差（MD）和 95%置信区间（CI），并使用 I 统计量评估异质性。
我们纳入了 11 项研究，共 470 例患者，其中 34.6%为女性。患者平均年龄为 43.7 岁至 60.7 岁。在 RFCA 后的随访期间，静息时（MD-60.25mmHg；95%CI[-70.53；-59.14mmHg]；p<0.01）和刺激时（MD-83.56mmHg；95%CI[-100.36；-66.76mmHg]；p<0.01）左心室流出道（LVOT）梯度均有显著降低。此外，RFCA 降低了室间隔（IVS）厚度（MD-3.61mm；95%CI[-5.64；-1.59mm]；p=0.01）和纽约心脏协会（NYHA）分级（MD-1.46；95%CI[-1.69；-1.24]；p<0.01）。
在 HOCM 患者中，RFCA 与 NYHA 分级改善、IVS 厚度降低以及静息和刺激时 LVOT 梯度降低相关。
