Septal Ablation for Obstructive HCM

Not Applicable

Recruiting

• Conditions: Hypertrophic Obstructive Cardiomyopathy (HOCM)
• Interventions: Device: percutaneous intramyocardial septal radiofrequency ablation system

• Registration Number: NCT06277960
• Lead Sponsor: SuZhou Sinus Medical Technologies Co.,Ltd

Brief Summary

Hypertrophic cardiomyopathy (HCM) is a common clinical genetic-related disease, with a global incidence of 0.2%-0.5%, but only a few cases (10-20%) have been clinically diagnosed. About 70% of them are hypertrophic obstructive cardiomyopathy (HOCM), these HOCM patients have significant clinical symptoms, including progressively increasing fatigue, angina, exertional dyspnea, and syncope. Conservative medications are used to treat the vast majority of patients. Invasive therapy, which includes surgical myectomy, percutaneous transluminal septal myocardial ablation(PTSMA), percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) and percutaneous endocardial septal radiofrequency ablation (PESA) is introduced to patients with refractory symptoms or drug resistance. However, surgical operations are complicated and high risk procedures with high mortality. Interventional approaches are very difficult to perform and therefore the application is limited.

Previous researches have shown that interventricular septal radiofrequency ablation could effectively reduce the left ventricular outflow tract pressure gradient (LVOTG), thereby treating obstructive hypertrophic cardiomyopathy (HOCM). This device is based on the same radiofrequency ablation energy principle, however, the catheter is introduced into the right ventricle and performs ablation treatment on the hypertrophic interventricular septum, which is potentially a lower risk route of access for septal ablation than currently attempted interventional approaches.

The purpose of this study is to evaluate the safety and efficacy of percutaneous intramyocardial septal ablation catheters in the treatment of obstructive hypertrophic cardiomyopathy.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2024-01-27
• Study First Submitted QC: 2024-02-18
• Study First Posted: 2024-02-26
• Study Start: 2024-03-28
• Status Verified: 2024-05
• Last Update Submitted: 2024-05-30
• Last Update Posted: 2024-05-31
• Primary Completion: 2024-06-30
• Study Completion: 2024-11-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 15

Inclusion Criteria

1. 18 years old ≤ age ≤ 75 years old, no gender limit.
2. Subject has pressure gradient of left ventricular outflow tract (LVOT) ≥50 mmHg（with Systolic Anterior Motion）in the resting-state or after exercise stress test.
3. Subject with New York Heart Association (NYHA) cardiac function ≥ II grade.
4. Subject with adequate drug treatment is not effective or cannot tolerate side effects of the drug.
5. Subject was informed of the nature of the clinical study and agreed to participate in all the requirements of the clinical study, signed an ethics committee-approved informed consent form before conducting any special examinations and/or treatments related to the clinical study.

Exclusion Criteria

1. Subject is pregnant, lactating, or planned to conceive during a clinical study.
2. Subject with interventricular septal thickness ≥ 30mm.
3. Subject has undergone other ventricular septal volume reduction surgeries.
4. Subject with complete right bundle branch block on electrocardiogram.
5. Subject with Sudden Cardiac Death Index ≥ 10%.
6. Subject combined with other heart diseases requires surgical treatment.
7. Subject with heart failure(Defined as resting heart failure after intensive anti-heart failure therapy, left ventricular fraction of ejecting< 40%).
8. Subject is mentally incapacitated or unable to understand the study requirements.
9. Subject has participated in other clinical trials within 3 months.
10. The investigator determines that there is any situation that affects the safety of the subjects or interferes with the evaluation of test results.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
percutaneous intramyocardial septal radiofrequency ablation system	percutaneous intramyocardial septal radiofrequency ablation system	-

Primary Outcome Measures

Name	Time	Method
30-day major adverse clinical events (MACE)	30-day	30-day major adverse clinical events (MACE), including death, emergency surgery, severe pericardial effusion bleeding requiring pericardiocentesis or surgery, atrioventricular block, heart perforation, and surgery-related stroke.

Secondary Outcome Measures

Name	Time	Method
Improvement of NYHA functional classification	6 months	The improvement of NYHA functional class at post-procedure,30 days,3 months and 6 months after procedure. The lower class mean a better outcome.
Technical success rate	30-day	Technical success rate: the radiofrequency ablation catheter reaches the required treatment site, successfully completes the ablation, and is successfully withdrawn from the body.
Improvement of left ventricular outflow tract gradient (LVOTG)	6 months	The improvement of LVOTG at post-procedure,30 days,3 months and 6 months after procedure. If the pressure gradient is reduced, the symptom will improve.
6-min walk distance	6 months	The increase of 6-min walk distance at post-procedure,30 days,3 months and 6 months after procedure.
Short Form 36 (SF-36) health survey questionnaire	90-day	The life quality score of SF-36 would significantly improved after the procedure. The higher scores mean a better outcome.

Trial Locations

Locations (1)

Sir Run Run Shaw Hospital; 🇨🇳 Hangzhou, Zhejiang, China