Percutaneous Endocardial Septal Pulsed Field Ablation for Hypertrophic Obstructive Cardiomyopathy: A Case Report

ABSTRACT A 53‐year‐old man was diagnosed with hypertrophic obstructive cardiomyopathy (HOCM). Transthoracic echocardiography (TTE) demonstrated a basal interventricular septal thickness of 13.7 mm and a left ventricular outflow tract gradient (LVOTG) of 73 mmHg. Under intracardiac echocardiography and three‐dimensional electroanatomical mapping system guidance, the patient underwent percutaneous endocardial septal pulsed field ablation (PES‐PFA). Clinical improvement was achieved. Invasive assessment showed the transaortic pressure gradient decreased from 59 to 32 mmHg. At 1‐month follow‐up, TTE confirmed LVOTG reduction to 40 mmHg. This case highlights PES‐PFA as a novel approach for HOCM, though further investigation is warranted to establish its safety and efficacy.