Percutaneous intramyocardial septal radiofrequency ablation for the treatment of obstructive hypertrophic cardiomyopa-thy:postoperative electrocardiogram changes
Objective To observe the ECG changes in patients with obstructive hypertrophic cardiomyopathy(HOCM)1 week after percutaneous intramyocardial septal radiofrequency ablation(PIMSRA)and 6 months after PIMSRA through dynamic electrocardiography and echocardiography(UCG).Methods Patients diagnosed with HOCM and treated with PIMSRA from June 2020 to February 2023 were included.Their clinical data,past history,risk factors,New York heart function,etc.were collected;before surgery,1 week after PIMSRA,and 6 months after PIMSRA,24-hour dynamic electrocardiography was used to evaluate heart rate,ventricular arrhythmias,and supraventricular arrhythmias,ST segment changes and conduction block changes;UCG was used to measure inter-ventricular septal thickness,left ventricular outflow tract pressure difference,left ventricular ejection fraction,and systolic anterior mitral valve anterior leaflet motion(SAM sign).The changes in the above indicators before PIM-SRA,1 week after PIMSRA,and 6 months after PIMSRA were evaluated.Results Ninety-nine patients were consecutively included,aged(44.7±13.8)years old,67.7％were male,and 41.4％had heart failure.After receiv-ing PIMSRA,compared with before surgery,the proportion of the fastest heart rate was significantly reduced in the first week after surgery,the total number of premature ventricular contractions(PVC),short burst ventricular tachycardia,the proportion of maximum ST segment elevation values increased significantly;6 months after surgery,there were no statistical differences in the fas-test heart rate,total number of PVC,short bursts of ventricular tachycardia,and maximum ST segment elevation values compared with those before surgery;8 cases(8.1％)transient conduction block and interfering disjoint occurred 1 week after surgery(4 cases of complete right bundle branch block,4 cases of interfering disjoint and accelerated junctional rhythm,and 1 case of intraventricular conduction block),and the results were normal before surgery and 6 months after surgery;1 case(1.0％)devel-oped permanent complete right bundle branch block.Compared with those before surgery,at 1 week and 6 months after surgery,the interventricular septal thickness and outflow tract pressure difference were significantly reduced(P＜0.05),and the NYHA class Ⅰ rate and SAM sign negative rate were significantly increased(P＜0.05),no sig-nificant increase or decrease was found in the remaining indicators.Conclusion One week after P1MSRA,the number of PVC increased,ventricular arrhythmia events increased,and the ST segment elevation at the ablation site increased.8.1％of patients developed various transient conduction blocks,interfering disjoints,and junctional disor-ders 1 week after PIMSRA.1.0％of patients developed permanent complete right bundle branch block after PIM-SRA.[Chinese Journal of Cardiac Pacing and Electrophysiology,2024,38(2):100-104]
CardiologyObstructive hypertrophic cardiomyopathyPercutaneous intramyocardial radiofrequency ablation of the ventricular septumDynamic electrocardiogramEchocardiography
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