Endocardial radiofrequency septal ablation for hypertrophic obstructive cardiomyopathy:two case reports
Endocardial radiofrequency ablation of the septal hypertrophy (ERASH) is an alternative for hypertrophic obstructive cardiomyopathy (HOCM). Radiofrequency ablation could lead to regional myocardial akinesia, so as to relieve the left ventricular outflow tract (LVOT) gradient. We reported that two patients presented Left ventricular asymmetric hypertrophy in transthoracic echocardiography, and were diagnosed with HOCM. One had a gradient up to 210mmHg during the provocation. The other had a gradient of LVOT up to 108mmHg at rest. Both are symptomatic despite of the optimized medication. Due to the restriction of coronary anatomy, the patients lost the opportunity for the alcohol septal ablation (ASA). ERASH is programmed. The target site was determined by intracardial echocardiography and electroanatomic Carto-mapping system. ERASH caused the targeted myocardium hypokinesia precisely, aiming for interdicting mitral valve systolic anterior motion. 1-month follow-up showed a remarkable improvement of clinical state and a predominant reduction of LVOT gradient assessing by transthoracic echocardiography. ERASH comes up with a new solution for the patient who is not candidate for ventricular septal myectomy and ASA. Carto-mapping system and intracardiac echocardiography enable precise lesion placement and preservation of atrioventricular conduction.
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Posted 14 Jan, 2020
Endocardial radiofrequency septal ablation for hypertrophic obstructive cardiomyopathy:two case reports
Posted 14 Jan, 2020
Endocardial radiofrequency ablation of the septal hypertrophy (ERASH) is an alternative for hypertrophic obstructive cardiomyopathy (HOCM). Radiofrequency ablation could lead to regional myocardial akinesia, so as to relieve the left ventricular outflow tract (LVOT) gradient. We reported that two patients presented Left ventricular asymmetric hypertrophy in transthoracic echocardiography, and were diagnosed with HOCM. One had a gradient up to 210mmHg during the provocation. The other had a gradient of LVOT up to 108mmHg at rest. Both are symptomatic despite of the optimized medication. Due to the restriction of coronary anatomy, the patients lost the opportunity for the alcohol septal ablation (ASA). ERASH is programmed. The target site was determined by intracardial echocardiography and electroanatomic Carto-mapping system. ERASH caused the targeted myocardium hypokinesia precisely, aiming for interdicting mitral valve systolic anterior motion. 1-month follow-up showed a remarkable improvement of clinical state and a predominant reduction of LVOT gradient assessing by transthoracic echocardiography. ERASH comes up with a new solution for the patient who is not candidate for ventricular septal myectomy and ASA. Carto-mapping system and intracardiac echocardiography enable precise lesion placement and preservation of atrioventricular conduction.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5