Body surface electrocardiogram in percutaneous myocardial chamber interval radiofrequency ablation in treatment of obstructive hypertrophic cardiomyopathy

  AIM  To investigate the effect of surface electrocardiogram (ECG) in percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) for patients with hypertrophic obstructive cardiomyopathy (HOCM).

  METHODS  Forty-six HOCM patients who were treated with PIMSRA between April 2017 to November 2018 in Hypertrophic Cardiomyopathy Center, Xijing Hospital of Air Force Medical University, were enrolled and their ECG parameters were analyzed retrospectively, which include the QRS width (AVF, V1); R + S wave voltage in leads AVF, V1, V2 and V3; ST segment elevation or depression in leads V1, V2, V3 and V5; Sv1+Rv5 voltage before the procedure, after 1 week, 1 month, 3 month, and 6 month respectively. Furthermore, arrhythmia events during a two-year follow-up were also evaluated by surface ECG.

  RESULTS  Compared with those ECG before the operation, the sum of R wave and S wave voltage in leads V1 and V2 decreased significantly in 6 months after the operation, and ST in leads V1 and V2 elevated significantly in 1 week after operation. Compared with those 1 week after operation, ST in leads V1 and V2 depressed significantly in 3 and 6 months. Two patients developed new complete right bundle branch block (RBBB) and 4 patients recovered to normal sinus rhythm one year after operation.

  CONCLUSION  PIMSRA is a safe and effective new technique for the treatment of obstructive hypertrophic cardiomyopathy. ECG plays an important guidance and monitoring role during perioperative period.