Impact of Liwen Procedure in Obstructive Hypertrophic Cardiomyopathy on Arrhythmias

Xijing Hospital350 enrolled

Overview

The goal of this observational study is to learn about the occurrence of various arrhythmias ( tachyarrhythmia and bradyarrhythmia ) during or after Percutaneous Intramyocardial Septal Radiofrequency Ablation. The main questions it aims to answer are: * To investigate the occurrence of various arrhythmias ( tachyarrhythmia and bradyarrhythmia ) during procedure and its relationship with clinical characteristics and procedural parameters * To analyze the changes of 12-lead electrocardiogram and 24-hour dynamic electrocardiogram before and after Percutaneous Intramyocardial Septal Radiofrequency Ablation and their relationships with clinical characteristics and procedural parameters

Study Type

OBSERVATIONAL

Enrollment

350

Conditions

Hypertrophic Cardiomyopathy Arrhythmia

Interventions

Percutaneous Intramyocardial Septal Radiofrequency Ablation for hypertrophic obstructive cardiomyopathy (Liwen Procedure)

Under transthoracic echocardiography (TTE) guidance, the puncture site is positioned at the apex. A guiding line is applied along the septal long axis and the radiofrequency ablation electrode needle(17G, Cool-tip™ RF Ablation System and Switching Controller; Medtronic, Minneapolis, MN, USA) pierced towards the hypertrophic anterior interventricular septum (AIVS) 8-10 mm from the subaortic valve. Each ablation lasts up to 12 min, and the ablation power gradually increases from 30-40W. Then, the ablation needle is withdrawn 10 mm to prepare for the next application. Overall, 3-4 applications are performed in each patient. The ablation creates an area of thermal coagulative myocardial necrosis that appears as a hyperechogenic reflection detected by TTE. If deemed necessary, we repeat the procedure at the posterior interventricular septum (PIVS).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Subject with symptoms that limit daily activities (New York Heart Association functional class \>II, exercise-induced syncope) despite adequate medical treatment or when medical treatment is not tolerated 2. Subject with a peak LVOT gradient≥50 mm Hg 3. Subject volunteers for the Liwen procedure and received the procedure at the Hypertrophic Cardiomyopathy Center of Xijing Hospital. Exclusion Criteria: 1. Subject with a peak instantaneous Doppler LVOT gradient of \<50 mm Hg 2. Subject with an indication for septal reduction therapy and other lesions requiring surgical intervention (e.g., mitral valve repair/replacement and papillary muscle intervention) 3. Subject has end-stage heart failure

Outcomes

Primary Outcomes

All-cause and cardiovascular mortality

All-cause and cardiovascular mortality (defined as sudden cardiac death, Heart Failure-related death, and heart transplant) were the primary outcomes.

Time frame: From date of procedure until the date of first occurrence of outcome, assessed up to 1 years

Secondary Outcomes

Ventricular tacharrhythmia composite outcome

Unexplained syncope, resuscitated cardiac arrests, or appropriate implantable cardioverter-defibrillator charge.

Time frame: From date of procedure until the date of first occurrence of outcome, assessed up to 1 years

Arrhythmia

Complete heart block, new permanent pacemaker implantation, non-sustained ventricular tachycardia, sustained ventricular tachycardia, left bundle branch block, right bundle branch block, premature ventricular contractions burden more than 10% monitored by Holter.

Time frame: From date of procedure until the date of first occurrence of outcome, assessed up to 1 years

Impact of Liwen Procedure in Obstructive Hypertrophic Cardiomyopathy on Arrhythmias

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes