REFINE-HCM: Intramyocardial Septal Radiofrequency Ablation for Obstructive Hypertrophic Cardiomyopathy

Who May Qualify: - Age 18 to 80 years, regardless of sex - Diagnosed with obstructive hypertrophic cardiomyopathy (oHCM) - Presence of significant symptoms (e.g., dyspnea, chest pain, fatigue, palpitations, syncope) - NYHA class II or higher with LVOTG ≥50 mmHg at rest or provoked (assessed by echocardiography) - Septal thickness ≥15 mm - Unsuitable for surgical myectomy or refusal of surgery - Provided willing to sign a consent form and agree to complete follow-up Who Should NOT Join This Trial: - Asymptomatic or non-obstructive HCM - Septal thickness ≥30 mm - Mitral valve anatomy not suitable for ablation as judged by investigator - High risk of sudden cardiac death (SCD) requiring ICD implantation - Complete right bundle branch block at screening - Infective endocarditis, myocarditis, atrial myxoma, or intracardiac thrombus - Contraindication to transseptal access (e.g., septal patch) - Mechanical valves or history of aortic valve replacement - Severe heart failure with persistent symptoms and LVEF \<40% - Major cardiac events within 6 months (e.g., cardiac arrest, MI, heart failure hospitalization) - Significant structural heart disease requiring surgery - Prior septal reduction therapy or pacemaker implantation - Constrictive pericarditis or significant congenital heart disease - Bleeding disorders or contraindication to antithrombotic therapy - Liver dysfunction (ALT/AST \>3× ULN) - Renal insufficiency (creatinine \>2.0 mg/dL or on dialysis) - Pregnant, breastfeeding, or planning pregnancy within 6 months post-op - Life expectancy \<12 months - Participation in other investigational studies within 30 days or 5 half-lives - Investigator determines poor compliance or unsuitability - Contraindications to cardiac MRI (e.g., ICD, allergy to contrast, claustrophobia) Always talk to your doctor about whether this trial is right for you.