PO-04-097 ATRIOVENTRICULAR NODE ABLATION COMBINED WITH SEPTAL WALL MODIFICATION UTILIZING RADIOFREQUENCY APPLICATION IN PATIENTS WITH SYMPTOMATIC HYPERTROPHIC CARDIOMYOPATHY

Hypertrophic cardiomyopathy (HCM) is a genetic disease involving abnormal myocardium thickening. HCM can lead to dynamic left ventricular outflow tract obstruction (LVOT) that cause significant heart failure symptoms. A novel approach alleviate this LVOT involves atrioventricular node (AVN) ablation and right (RV) apical pacing along with radiofrequency (RF) an open irrigated catheter the thicker area of (LV) septum discussed in following case series. To assess effectiveness reduce gradients patients by employing septal wall modification RF AV RV pacing. Reported here series took place between 2016 2021 comprised eight cases HCM, severe symptoms failure, refractive medical therapy. The were first sedated; if not already present, device (either pacemaker or implantable defibrillator, based on clinical needs) was inserted. In those who required implant, implanted apex initiate activation as close LV possible. across LVOT, transesophageal echocardiography (TEE) without dobutamine performed. TEE 3D mapping results guided (panel A). Finally, performed induce complete block allow For all patients, peak acquired from pre post-procedure B). Baseline noted mean gradient 120.25 mmHg (± 59.61 mmHg). Post-RF (RFSA) ablation, reduced average 24.13 15.57 mmHg); t = 4.4130, p 0.0006. This treatment demonstrated 80% reduction. TEE-guided combined may provide alternative, minimally invasive option LVOT.