Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: a meta-analysis

Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic heart disease leading to obstructive hypertrophy. Radiofrequency ablation (RFA) is a minimally invasive alternative to traditional treatments. This review evaluates RFA’s effectiveness and safety for HOCM. A systematic review and meta-analysis were performed on studies from PubMed, Cochrane, and clinicaltrials.gov up to August 2024. Studies comparing RFA outcomes before and after the procedure were included. Data were analyzed through Revman software, using random-effects models. The funnel plots and Egger test were used for publication bias. Subgroup analysis and sensitivity analysis were also performed. This meta-analysis included 16 cohort studies and 2 case series, encompassing 727 patients with ages ranging from 10.4 to 62 years. The studies were conducted in various countries, including China, the USA, Germany, the UK, India, and Brazil. The analysis revealed significant improvements following radiofrequency ablation (RFA): the LVOT gradient at rest was reduced by MD −58.2 (CI: −71.2 to −56.93, <i>p</i> &lt; 0.00001), and the provoked gradient decreased by MD −81.05 (CI: −97.67 to −64.42, <i>p</i> &lt; 0.00001). RFA effectively reduces both LVOT gradients at rest and provoked, improves NYHA functional class, and decreases septal size in HOCM patients. Hypertrophic obstructive cardiomyopathy (HOCM) is a heart disease where the heart’s muscle becomes abnormally thick, making it harder for blood to flow out of the heart.Radiofrequency ablation (RFA) is a procedure that uses heat to treat the thickened part of the heart muscle and improve blood flow. This study looked at the effectiveness and safety of RFA in patients with HOCM.After reviewing 18 studies with over 700 patients, the analysis found that RFA significantly improved the heart’s ability to pump blood, reduced symptoms of heart failure, and decreased the size of the thickened heart muscle.While the procedure has some risks, including pericardial effusion (fluid around the heart) and heart rhythm problems, the benefits were clear. The study suggests that RFA is a promising treatment for patients who cannot undergo traditional heart surgery.More research is needed to confirm long-term benefits and identify the best patients for this treatment. www.crd.york.ac.uk/prospero, identifier CRD42024585281.