About: Ablation of Hypertrophic Septum Using Radiofrequency Energy - An Alternative for Gradient Reduction in Patient With Hypertrophic Obstructive Cardiomyopathy?     Goto   Sponge   NotDistinct   Permalink

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Description
  • Introduction. Alcohol septal ablation and surgical myectomy represent accepted therapeutic options for treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy. Long-term experience with radiofrequency ablation of arrhythmogenic substrates raised a question if this technique might be effective for left ventricular outflow tract (LVOT) gradient reduction. Case report. We report on a 63-year-old patient with recurrence of symptoms 1 year after alcohol septal ablation (ASA) leading originally to a significant reduction of both symptoms and gradient. Due to a new increase of gradient in the LVOT up to 200 mm Hg with corresponding worsening of symptoms and due to refusal of surgical myectomy by the patient, endocardial radiofrequency ablation of the septal hypertrophy (ERASH) was indicated. Radiofrequency ablation was performed in the LVOT using irrigated-tip ablation catheter; the target site was identified using intracardiac echocardiography and electroanatomical CARTO mapping. ERASH caused an immediate gradient reduction due to hypokinesis of the ablated septum. At 2-month follow-up exam, significant clinical improvement was observed, together with persistent gradient reduction assessed with Doppler echocardiography. Echocardiography and magnetic resonance revealed persistent septal hypokinesis and slight thinning of the ablated region. Conclusion. Septal ablation using radiofrequency energy may be a promising alternative or adjunct to the treatment of hypertrophic obstructive cardiomyopathy. Intracardiac echocardiography and electroanatomical CARTO mapping enable exact lesion placement and preservation of atrioventricular conduction.
  • Introduction. Alcohol septal ablation and surgical myectomy represent accepted therapeutic options for treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy. Long-term experience with radiofrequency ablation of arrhythmogenic substrates raised a question if this technique might be effective for left ventricular outflow tract (LVOT) gradient reduction. Case report. We report on a 63-year-old patient with recurrence of symptoms 1 year after alcohol septal ablation (ASA) leading originally to a significant reduction of both symptoms and gradient. Due to a new increase of gradient in the LVOT up to 200 mm Hg with corresponding worsening of symptoms and due to refusal of surgical myectomy by the patient, endocardial radiofrequency ablation of the septal hypertrophy (ERASH) was indicated. Radiofrequency ablation was performed in the LVOT using irrigated-tip ablation catheter; the target site was identified using intracardiac echocardiography and electroanatomical CARTO mapping. ERASH caused an immediate gradient reduction due to hypokinesis of the ablated septum. At 2-month follow-up exam, significant clinical improvement was observed, together with persistent gradient reduction assessed with Doppler echocardiography. Echocardiography and magnetic resonance revealed persistent septal hypokinesis and slight thinning of the ablated region. Conclusion. Septal ablation using radiofrequency energy may be a promising alternative or adjunct to the treatment of hypertrophic obstructive cardiomyopathy. Intracardiac echocardiography and electroanatomical CARTO mapping enable exact lesion placement and preservation of atrioventricular conduction. (en)
Title
  • Ablation of Hypertrophic Septum Using Radiofrequency Energy - An Alternative for Gradient Reduction in Patient With Hypertrophic Obstructive Cardiomyopathy?
  • Ablation of Hypertrophic Septum Using Radiofrequency Energy - An Alternative for Gradient Reduction in Patient With Hypertrophic Obstructive Cardiomyopathy? (en)
skos:prefLabel
  • Ablation of Hypertrophic Septum Using Radiofrequency Energy - An Alternative for Gradient Reduction in Patient With Hypertrophic Obstructive Cardiomyopathy?
  • Ablation of Hypertrophic Septum Using Radiofrequency Energy - An Alternative for Gradient Reduction in Patient With Hypertrophic Obstructive Cardiomyopathy? (en)
skos:notation
  • RIV/00216208:11130/13:10196721!RIV14-MSM-11130___
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I
http://linked.open...iv/cisloPeriodika
  • 6
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 59226
http://linked.open...ai/riv/idVysledku
  • RIV/00216208:11130/13:10196721
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • magnetic resonance; echocardiography; electroanatomical mapping; radiofrequency ablation; septal ablation; hypertrophic cardiomyopathy (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [880221ADBDB3]
http://linked.open...i/riv/nazevZdroje
  • Journal of Invasive Cardiology
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 25
http://linked.open...iv/tvurceVysledku
  • Janoušek, Jan
  • Veselka, Josef
  • Riedlbauchová, Lucie
http://linked.open...ain/vavai/riv/wos
  • 000321121300004
issn
  • 1042-3931
number of pages
http://localhost/t...ganizacniJednotka
  • 11130
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