Open-Irrigated Helical Radiofrequency Septal Ablation for Obstructive Hypertrophic Cardiomyopathy.

BACKGROUND

Septal reduction therapy is recommended for symptomatic obstructive hypertrophic cardiomyopathy (oHCM) refractory to guideline-directed medical therapy.

CASE SUMMARY: A 60-year-old man with drug-refractory oHCM underwent Percutaneous Helical Ablation of Septal hypErtrophy, using a novel, dedicated, open-irrigated helical radiofrequency catheter via subclavian venous access. The provoked left ventricular outflow tract gradient decreased immediately after ablation from 130 to 30 mm Hg, with sustained improvement at 12 months, septal fibrosis on 6-month cardiac magnetic resonance, symptomatic improvement, and no procedural or follow-up complications.

DISCUSSION: This case report describes the first clinical use of a novel intervention strategy in oHCM. The hemodynamic benefit might be related to reduced septal contractility and a modest decrease in septal thickness.

TAKE-HOME MESSAGE: This case demonstrates an ablation procedure using a dedicated open-irrigated helical radiofrequency catheter through subclavian venous access in oHCM.