Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta‐analysis
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. Hypoth...
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| Vydáno v: | Clinical cardiology (Mahwah, N.J.) Ročník 43; číslo 5; s. 450 - 458 |
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Wiley Periodicals, Inc
01.05.2020
John Wiley & Sons, Inc |
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| ISSN: | 0160-9289, 1932-8737, 1932-8737 |
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| 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. |
|---|---|
| AbstractList | 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. 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.BACKGROUNDAlthough 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.Radiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM.HYPOTHESISRadiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM.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.METHODSA 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.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.RESULTSEight 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.Radiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM.CONCLUSIONSRadiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM. BackgroundAlthough 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.HypothesisRadiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM.MethodsA 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.ResultsEight 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.ConclusionsRadiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM. 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. Radiofrequency septal ablation is effective and safe for relieving obstruction and improving exercise capacity in patients with HOCM. 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. 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. Radiofrequency septal ablation is effective and safe for relieving LVOT obstruction and improving exercise capacity in patients with HOCM. |
| Author | Yang, Yuan Luo, Suxin Yang, Haonan Xue, Yuzhou |
| AuthorAffiliation | 1 Department of Cardiology The First Affiliated Hospital of Chongqing Medical University Chongqing China |
| AuthorAffiliation_xml | – name: 1 Department of Cardiology The First Affiliated Hospital of Chongqing Medical University Chongqing China |
| Author_xml | – sequence: 1 givenname: Haonan orcidid: 0000-0003-2291-9299 surname: Yang fullname: Yang, Haonan organization: The First Affiliated Hospital of Chongqing Medical University – sequence: 2 givenname: Yuan orcidid: 0000-0003-3392-996X surname: Yang fullname: Yang, Yuan organization: The First Affiliated Hospital of Chongqing Medical University – sequence: 3 givenname: Yuzhou orcidid: 0000-0002-7222-9440 surname: Xue fullname: Xue, Yuzhou organization: The First Affiliated Hospital of Chongqing Medical University – sequence: 4 givenname: Suxin orcidid: 0000-0003-4524-5979 surname: Luo fullname: Luo, Suxin email: luosuxin0204@163.com organization: The First Affiliated Hospital of Chongqing Medical University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32034788$$D View this record in MEDLINE/PubMed |
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| Keywords | meta-analysis septal reduction therapy hypertrophic obstructive cardiomyopathy radiofrequency ablation |
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Although radiofrequency ablation is widely used in the treatment of arrhythmias, its role in septal reduction therapy of hypertrophic obstructive... Although radiofrequency ablation is widely used in the treatment of arrhythmias, its role in septal reduction therapy of hypertrophic obstructive... BackgroundAlthough radiofrequency ablation is widely used in the treatment of arrhythmias, its role in septal reduction therapy of hypertrophic obstructive... |
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| SubjectTerms | Ablation Aged Cardiomyopathy Cardiomyopathy, Hypertrophic - physiopathology Cardiomyopathy, Hypertrophic - surgery Catheters Echocardiography - methods Edema Female Humans hypertrophic obstructive cardiomyopathy Male Meta-analysis Middle Aged Patients radiofrequency ablation Radiofrequency Ablation - methods Review Reviews septal reduction therapy Statistical analysis Studies Surgery, Computer-Assisted - methods Systematic review Treatment Outcome |
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| Title | Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta‐analysis |
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