Xu Guiwen, Sun Qiaobing, Wang Lin, Gong Han, Tan Ruopeng, Xia Yun-Long, Liu Yang, Yin Xiaomeng
Institute of Cardiovascular Diseases, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
J Cardiovasc Electrophysiol. 2025 Sep;36(9):2353-2362. doi: 10.1111/jce.70015. Epub 2025 Jul 21.
Hypertrophic obstructive cardiomyopathy is characterized by hypertrophy of the interventricular septum with the presence of significant left ventricular outflow tract (LVOT) pressure gradients, and one approach to reduce LVOT pressure gradients in this context is through endocardial radiofrequency catheter ablation (RFCA). However, the therapeutic effects of current treatment methods remain to be better improved. Here, we tested the efficacy of RFCA using a retractable needle-tipped catheter (needle catheter).
Eight healthy dogs underwent RFCA of the interventricular septum using a needle catheter (n = 4) or a cold saline perfusion catheter (conventional catheter, n = 4). Following each procedure, cardiac structure and function, including the thickness as well as movements of the interventricular septum, were assessed by echocardiography pre-ablation, 1-month and 3-months postablation, and lesions created by each of the two catheters in the healthy dogs were identified by Masson's staining. Three months after RFCA, compared to samples manipulated using conventional catheters, septal movement was significantly reduced in samples treated with needle catheters. Masson's staining indicated that lesions created by the conventional catheter were on the endocardial surface, while lesions created by the needle catheter were delectable under the endocardial surface, and were also found to be deeper and more expanded.
Ablation of the interventricular septum in healthy dogs using a needle catheter led to more pronounced effects on septal movement compared to procedures using a conventional catheter, without compromising safety.
肥厚型梗阻性心肌病的特征是室间隔肥厚并伴有显著的左心室流出道（LVOT）压力梯度，在这种情况下，降低LVOT压力梯度的一种方法是通过心内膜射频导管消融（RFCA）。然而，目前治疗方法的疗效仍有待进一步提高。在此，我们测试了使用可伸缩针尖导管（针导管）进行RFCA的疗效。
八只健康犬接受了使用针导管（n = 4）或冷盐水灌注导管（传统导管，n = 4）对室间隔进行的RFCA。每次手术后，在消融前、消融后1个月和3个月通过超声心动图评估心脏结构和功能，包括室间隔的厚度以及运动情况，并通过Masson染色识别两只导管在健康犬体内造成的损伤。RFCA三个月后，与使用传统导管处理的样本相比，使用针导管处理的样本中，间隔运动显著减少。Masson染色表明，传统导管造成的损伤位于心内膜表面，而针导管造成的损伤在内膜表面以下可见，并且发现更深、范围更广。
与使用传统导管的手术相比，在健康犬中使用针导管消融室间隔对间隔运动产生的影响更为显著，且不影响安全性。
