Radiofrequency in Obstructive Hypertrophic Cardiomyopathy: The Role of Imaging in the Assessment of Septal Thickness and Gradient Reduction

Obstructive hypertrophic cardiomyopathy (HCM) is a genetic disorder characterized by pronounced myocardial hypertrophy and varying degrees of fibrosis. The obstruction of the left ventricular outflow tract (LVOT) is an anatomical condition with dynamic behavior that can lead to symptoms such as exercise intolerance and reduced functional class, and is also associated with cases of sudden cardiac death.

The indication for invasive treatment aimed at reducing the intraventricular gradient is reserved for symptomatic patients —those who are refractory to medical therapy — with a gradient ≥ 50 mmHg. Common interventional therapies for this condition include surgical myectomy or, in a less invasive approach, alcohol septal ablation of coronary septal branches. However, these interventions have shown highly variable outcomes in the literature and remain infrequently used in clinical practice.^,

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