Video. Percutaneous Intramyocardial Septal Radiofrequency Ablation (PIMSRA) .
This animation and additional live case show the steps to perform the novel PIMSRA procedure. With the patient under general anesthesia, real-time echocardiographic guidance is used to position a radiofrequency electrode needle using a puncture guide over the apex of the heart. The needle is inserted into the interventricular septum via a percutaneous transapical intramyocardial approach. High-frequency alternating current is applied, resulting in irreversible coagulation necrosis of the tissue and regional blood vessels. Basal and mid portions of anterior and posterior septum can be targeted to ensure efficacy. Contrast echocardiography is performed to assess the ablation region, and a comprehensive Doppler assessment is performed to assess hemodynamic improvement.