Percutaneous Endocardial Septal Pulsed Field Ablation for Hypertrophic Obstructive Cardiomyopathy: A Case Report

A 53-year-old man was diagnosed with hypertrophic obstructive cardiomyopathy (HOCM). Transthoracic echocardiography (TTE) demonstrated a basal interventricular septal thickness of 13.7 mm and a left ventricular outflow tract gradient (LVOTG) of 73 mmHg. Under intracardiac echocardiography and three-dimensional electroanatomical mapping system guidance, the patient underwent percutaneous endocardial septal pulsed field ablation (PES-PFA). Clinical improvement was achieved. Invasive assessment showed the transaortic pressure gradient decreased from 59 to 32 mmHg. At 1-month follow-up, TTE confirmed LVOTG reduction to 40 mmHg. This case highlights PES-PFA as a novel approach for HOCM, though further investigation is warranted to establish its safety and efficacy.