Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis

Fatema Tashrifwala; Manisha Purushotham; Sai Krishna Bhushan

doi:doi:10.11648/j.ijcts.20230902.12

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Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis

Fatema Tashrifwala, Manisha Purushotham, Sai Krishna Bhushan

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 2)

Received: 8 February 2023 Accepted: 25 February 2023 Published: 29 May 2023

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Abstract

In this study, we aimed to meta-analyze all available data to provide a holistic, well-powered assessment of the effect of PIMSRA on LVOT gradient, LVEF, and anterior and posterior IVS thickness. PubMed, Cochrane Central, Embase, and Scopus were systematically searched from inception till October 2022 for published clinical trials assessing the efficacy of PIMSRA in patients with HCM using the keywords “PIMSRA” OR “Percutaneous Intramyocardial Septal Radiofrequency Ablation” OR “Liwen procedure. All five studies reported a change in LVOT gradient from the baseline. Integrated analysis showed no significant change from baseline (MD: -69.506; 95% CI: -77.047, -61.966; P = 0.089) (I² = 50.4%). Subgroup analyses based on follow-up revealed that there was no significant difference noted at 6 months according to data from 2 studies (MD: -65.351; 95% CI; -85.253, -45.450; P = 0.181) (I²= 44.1%) however data from 3 studies at one year follow up did reveal a significant difference from baseline (MD: -71.010; 95% CI: -80.262, -61.758; P = 0.047) (I² = 67.2%). Only three studies reported changes in LVEF from the baseline. This single-arm meta-analysis of 284 patients gathered from 5 clinical trials suggested that overall, after PIMSRA, LVOT gradient was reduced, and LVEF was slightly decreased. Additionally, no significant changes were observed in the anterior and posterior IVS thicknesses.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 9, Issue 2)
DOI	10.11648/j.ijcts.20230902.12
Page(s)	17-21
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

HCOM, PIMSRA, LVOT, LVEF, Anterior IVS Thickness, Posterior IVS Thickness, Efficacy

References

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[2]	Marian AJ, Braunwald E. Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy. Circ Res. 2017 Sep 15; 121 (7): 749-770. doi: 10.1161/CIRCRESAHA.117.311059. PMID: 28912181; PMCID: PMC5654557.
[3]	Qian D, Zhou X, Liu H, Cao L. Clinical value of 2D speckle tracking imaging in evaluating the effect of percutaneous intramyocardial septal radiofrequency ablation in patients with hypertrophic obstructive cardiomyopathy. J Clin Ultrasound. 2021 Jul; 49 (6): 554-562. doi: 10.1002/jcu.22989. Epub 2021 Mar 6. PMID: 33675543.
[4]	Zhonghua Xin Xue Guan Bing Za Zhi. 2019 Apr 24; 47 (4): 284-290. Chinese. doi: 10.3760/cma.j.issn.0253-3758.2019.04.005. PMID: 31060187. Tuohy CV, Kaul S, Song HK, Nazer B, Heitner SB. Hypertrophic cardiomyopathy: the future of treatment. Eur J Heart Fail. 2020 Feb; 22 (2): 228-240. doi: 10.1002/ejhf.1715. Epub 2020 Jan 9. PMID: 31919938.
[5]	Burstein Waldman C, Owens A. A plain language summary of the EXPLORER-HCM study: mavacamten for obstructive hypertrophic cardiomyopathy. Future Cardiol. 2021 Oct; 17 (7): 1269-1275. doi: 10.2217/fca-2021-0044. Epub 2021 May 21. PMID: 34018809.
[6]	Liu L, Li J, Zuo L, Zhang J, Zhou M, Xu B, Hahn RT, Leon MB, Hsi DH, Ge J, Zhou X, Zhang J, Ge S, Xiong L. Percutaneous Intramyocardial Septal Radiofrequency Ablation for Hypertrophic Obstructive Cardiomyopathy. J Am Coll Cardiol. 2018 Oct 16; 72 (16): 1898-1909. doi: 10.1016/j.jacc.2018.07.080. PMID: 30309466.
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[8]	Liu LW, Zuo L, Zhou MY, Li J, Zhou XD, He GB, Zhang J, Zhang JZ, Liu B, Yang J, Xu B. [Efficacy and safety of transthoracic echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation for the treatment of patients with obstructive hypertrophic cardiomyopathy]. Zhonghua Xin Xue Guan Bing Za Zhi. 2019 Apr 24; 47 (4): 284-290. Chinese. doi: 10.3760/cma.j.issn.0253-3758.2019.04.005. PMID: 31060187.
[9]	Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007 Sep; 93 (9): 1137-46. doi: 10.1136/hrt.2003.025270. PMID: 17699180; PMCID: PMC1955040.
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APA Style

Fatema Tashrifwala, Manisha Purushotham, Sai Krishna Bhushan. (2023). Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis. International Journal of Cardiovascular and Thoracic Surgery, 9(2), 17-21. https://doi.org/10.11648/j.ijcts.20230902.12

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ACS Style

Fatema Tashrifwala; Manisha Purushotham; Sai Krishna Bhushan. Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(2), 17-21. doi: 10.11648/j.ijcts.20230902.12

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AMA Style

Fatema Tashrifwala, Manisha Purushotham, Sai Krishna Bhushan. Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis. Int J Cardiovasc Thorac Surg. 2023;9(2):17-21. doi: 10.11648/j.ijcts.20230902.12

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@article{10.11648/j.ijcts.20230902.12,
  author = {Fatema Tashrifwala and Manisha Purushotham and Sai Krishna Bhushan},
  title = {Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {9},
  number = {2},
  pages = {17-21},
  doi = {10.11648/j.ijcts.20230902.12},
  url = {https://doi.org/10.11648/j.ijcts.20230902.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230902.12},
  abstract = {In this study, we aimed to meta-analyze all available data to provide a holistic, well-powered assessment of the effect of PIMSRA on LVOT gradient, LVEF, and anterior and posterior IVS thickness. PubMed, Cochrane Central, Embase, and Scopus were systematically searched from inception till October 2022 for published clinical trials assessing the efficacy of PIMSRA in patients with HCM using the keywords “PIMSRA” OR “Percutaneous Intramyocardial Septal Radiofrequency Ablation” OR “Liwen procedure. All five studies reported a change in LVOT gradient from the baseline. Integrated analysis showed no significant change from baseline (MD: -69.506; 95% CI: -77.047, -61.966; P = 0.089) (I² = 50.4%). Subgroup analyses based on follow-up revealed that there was no significant difference noted at 6 months according to data from 2 studies (MD: -65.351; 95% CI; -85.253, -45.450; P = 0.181) (I²= 44.1%) however data from 3 studies at one year follow up did reveal a significant difference from baseline (MD: -71.010; 95% CI: -80.262, -61.758; P = 0.047) (I² = 67.2%). Only three studies reported changes in LVEF from the baseline. This single-arm meta-analysis of 284 patients gathered from 5 clinical trials suggested that overall, after PIMSRA, LVOT gradient was reduced, and LVEF was slightly decreased. Additionally, no significant changes were observed in the anterior and posterior IVS thicknesses.},
 year = {2023}
}

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TY  - JOUR
T1  - Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis
AU  - Fatema Tashrifwala
AU  - Manisha Purushotham
AU  - Sai Krishna Bhushan
Y1  - 2023/05/29
PY  - 2023
N1  - https://doi.org/10.11648/j.ijcts.20230902.12
DO  - 10.11648/j.ijcts.20230902.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 17
EP  - 21
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20230902.12
AB  - In this study, we aimed to meta-analyze all available data to provide a holistic, well-powered assessment of the effect of PIMSRA on LVOT gradient, LVEF, and anterior and posterior IVS thickness. PubMed, Cochrane Central, Embase, and Scopus were systematically searched from inception till October 2022 for published clinical trials assessing the efficacy of PIMSRA in patients with HCM using the keywords “PIMSRA” OR “Percutaneous Intramyocardial Septal Radiofrequency Ablation” OR “Liwen procedure. All five studies reported a change in LVOT gradient from the baseline. Integrated analysis showed no significant change from baseline (MD: -69.506; 95% CI: -77.047, -61.966; P = 0.089) (I² = 50.4%). Subgroup analyses based on follow-up revealed that there was no significant difference noted at 6 months according to data from 2 studies (MD: -65.351; 95% CI; -85.253, -45.450; P = 0.181) (I²= 44.1%) however data from 3 studies at one year follow up did reveal a significant difference from baseline (MD: -71.010; 95% CI: -80.262, -61.758; P = 0.047) (I² = 67.2%). Only three studies reported changes in LVEF from the baseline. This single-arm meta-analysis of 284 patients gathered from 5 clinical trials suggested that overall, after PIMSRA, LVOT gradient was reduced, and LVEF was slightly decreased. Additionally, no significant changes were observed in the anterior and posterior IVS thicknesses.
VL  - 9
IS  - 2
ER  -

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Author Information

Fatema Tashrifwala

Clinical Research Intern, Stamford Hospital, Connecticut, US
Manisha Purushotham

Clinical Research Intern, Stamford Hospital, Connecticut, US
Sai Krishna Bhushan

Clinical Research Intern, Stamford Hospital, Connecticut, US

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Plain Text BibTeX RIS

APA Style

Fatema Tashrifwala, Manisha Purushotham, Sai Krishna Bhushan. (2023). Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis. International Journal of Cardiovascular and Thoracic Surgery, 9(2), 17-21. https://doi.org/10.11648/j.ijcts.20230902.12

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ACS Style

Fatema Tashrifwala; Manisha Purushotham; Sai Krishna Bhushan. Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(2), 17-21. doi: 10.11648/j.ijcts.20230902.12

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AMA Style

Fatema Tashrifwala, Manisha Purushotham, Sai Krishna Bhushan. Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis. Int J Cardiovasc Thorac Surg. 2023;9(2):17-21. doi: 10.11648/j.ijcts.20230902.12

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@article{10.11648/j.ijcts.20230902.12,
  author = {Fatema Tashrifwala and Manisha Purushotham and Sai Krishna Bhushan},
  title = {Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {9},
  number = {2},
  pages = {17-21},
  doi = {10.11648/j.ijcts.20230902.12},
  url = {https://doi.org/10.11648/j.ijcts.20230902.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230902.12},
  abstract = {In this study, we aimed to meta-analyze all available data to provide a holistic, well-powered assessment of the effect of PIMSRA on LVOT gradient, LVEF, and anterior and posterior IVS thickness. PubMed, Cochrane Central, Embase, and Scopus were systematically searched from inception till October 2022 for published clinical trials assessing the efficacy of PIMSRA in patients with HCM using the keywords “PIMSRA” OR “Percutaneous Intramyocardial Septal Radiofrequency Ablation” OR “Liwen procedure. All five studies reported a change in LVOT gradient from the baseline. Integrated analysis showed no significant change from baseline (MD: -69.506; 95% CI: -77.047, -61.966; P = 0.089) (I² = 50.4%). Subgroup analyses based on follow-up revealed that there was no significant difference noted at 6 months according to data from 2 studies (MD: -65.351; 95% CI; -85.253, -45.450; P = 0.181) (I²= 44.1%) however data from 3 studies at one year follow up did reveal a significant difference from baseline (MD: -71.010; 95% CI: -80.262, -61.758; P = 0.047) (I² = 67.2%). Only three studies reported changes in LVEF from the baseline. This single-arm meta-analysis of 284 patients gathered from 5 clinical trials suggested that overall, after PIMSRA, LVOT gradient was reduced, and LVEF was slightly decreased. Additionally, no significant changes were observed in the anterior and posterior IVS thicknesses.},
 year = {2023}
}

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TY  - JOUR
T1  - Percutaneous Intramyocardial Septal Radiofrequency Ablation in Patients with Hypertrophic Cardiomyopathy –A Systematic Review and Meta-Analysis
AU  - Fatema Tashrifwala
AU  - Manisha Purushotham
AU  - Sai Krishna Bhushan
Y1  - 2023/05/29
PY  - 2023
N1  - https://doi.org/10.11648/j.ijcts.20230902.12
DO  - 10.11648/j.ijcts.20230902.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 17
EP  - 21
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20230902.12
AB  - In this study, we aimed to meta-analyze all available data to provide a holistic, well-powered assessment of the effect of PIMSRA on LVOT gradient, LVEF, and anterior and posterior IVS thickness. PubMed, Cochrane Central, Embase, and Scopus were systematically searched from inception till October 2022 for published clinical trials assessing the efficacy of PIMSRA in patients with HCM using the keywords “PIMSRA” OR “Percutaneous Intramyocardial Septal Radiofrequency Ablation” OR “Liwen procedure. All five studies reported a change in LVOT gradient from the baseline. Integrated analysis showed no significant change from baseline (MD: -69.506; 95% CI: -77.047, -61.966; P = 0.089) (I² = 50.4%). Subgroup analyses based on follow-up revealed that there was no significant difference noted at 6 months according to data from 2 studies (MD: -65.351; 95% CI; -85.253, -45.450; P = 0.181) (I²= 44.1%) however data from 3 studies at one year follow up did reveal a significant difference from baseline (MD: -71.010; 95% CI: -80.262, -61.758; P = 0.047) (I² = 67.2%). Only three studies reported changes in LVEF from the baseline. This single-arm meta-analysis of 284 patients gathered from 5 clinical trials suggested that overall, after PIMSRA, LVOT gradient was reduced, and LVEF was slightly decreased. Additionally, no significant changes were observed in the anterior and posterior IVS thicknesses.
VL  - 9
IS  - 2
ER  -

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