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Radiofrequency ablation in patients with obstructive hypertrophic cardiomyopathy: A systematic review and meta-analysis.
Canzi, Camila Cássia; do Prado Júnior, Edivalde Ribeiro; da Silva Menezes Júnior, Antônio; Rezende, Aline Lazara; Botelho, Silvia Marçal; Santos, Luciana da Ressurreição.
Afiliación
  • Canzi CC; Medicine School, Pontifical Catholic University of Goiás, Goiânia, GO, Brazil.
  • do Prado Júnior ER; Medicine School, Pontifical Catholic University of Goiás, Goiânia, GO, Brazil.
  • da Silva Menezes Júnior A; Medicine School, Pontifical Catholic University of Goiás, Goiânia, GO, Brazil.
  • Rezende AL; Internal Medicine Department, Federal University of Goiás, Goiânia, GO, Brazil.
  • Botelho SM; Medicine School, Pontifical Catholic University of Goiás, Goiânia, GO, Brazil.
  • Santos LDR; Internal Medicine Department, Federal University of Goiás, Goiânia, GO, Brazil.
Am Heart J Plus ; 24: 100229, 2022 Dec.
Article en En | MEDLINE | ID: mdl-38560638
ABSTRACT
Study

objective:

Hypertrophic cardiomyopathy (HCM) is a genetic disease that can cause left ventricular outflow tract (LVOT) obstruction. This study analyzed the efficacy of radiofrequency ablation (RA) in improving clinical and hemodynamic factors in patients receiving obstructive HCM refractory treatment. This evaluation was necessary because of the small number of studies on the effectiveness of this technique for obstructive HCM in the existing literature.

Design:

We used the PubMed, Embase, and Science Direct databases to identify randomized clinical trials and observational studies addressing the clinical and hemodynamic outcomes before and after RA in patients with HCM.

Participants:

We selected six articles published between 2011 and 2022, comprising 304 patients (mean age 45 years).

Interventions:

We performed a bias assessment using the ROBINS I tool, and meta-analysis processing was performed using the STATA program (v.16.0).

Results:

The left ventricular outflow tract (LVOT) gradient at rest and with stimulation decreased by 58.78 mmHg (p = 0.001) and 70.38 mmHg (total effect Z = 21.62; p < 0.0001), respectively. Additionally, the New York Heart Association (NYHA) functional class decreased by 0.43 (p = 0.001), indicating symptomatic and hemodynamic improvements. Furthermore, we observed a significant reduction in septal thickness (by 4 mm; p = 0.001).

Conclusions:

RA improved the NYHA functional class and LVOT gradient at rest and with stimulation and reduced septal thickness. These results suggest that RA is effective in patients refractory to pharmacological therapy and unsuitable for alcohol septal ablation or myectomy. However, more studies, including randomized clinical trials, should be conducted to define the role of RA in interventional therapies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am Heart J Plus Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am Heart J Plus Año: 2022 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos