{
  "abstract": "BackgroundIn obstructive hypertrophic cardiomyopathy, surgical myectomy is highly effective but carries a recognized risk of postoperative conduction disturbances. Percutaneous intramyocardial septal radiofrequency ablation (Liwen procedure) is a less invasive alternative, but head-to-head comparisons of longitudinal hemodynamic trajectories and conduction system safety remain scarce, limiting evidence-based treatment selection.\n\nMethodsThis single-center retrospective cohort included 211 patients treated 2018-2023 (124 Liwen, 87 modified Morrow myectomy). The primary longitudinal analysis included 133 patients with 1-year follow-up and serial data (75 Liwen, 58 modified Morrow myectomy).\n\nRepeated outcomes were analyzed using linear mixed-effects models and generalized estimating equations, adjusted for baseline covariates.\n\nResultsBoth procedures reduced LVOT gradient, but trajectories differed (interaction P=0.002). At 1 year, the covariate-adjusted mean LVOT gradient remained higher after Liwen than after myectomy (16.1 vs 1.3 mmHg, P<0.001). However, the adjusted 1-year predicted probability of new conduction abnormalities was markedly lower after Liwen (5% vs 62%, P<0.001), with no permanent pacemaker implantations in the Liwen group. Most patients achieved gradient <30 mmHg in both groups (82% vs 96%; nominal P=0.308). Liwen had shorter procedure duration (80 vs 185 min) and hospital stay (11 vs 16 days). Serious adverse event rates were similar (8.1% vs 9.2%) but profiles differed.\n\nConclusionsModified Morrow myectomy achieved more complete LVOT gradient reduction at 1 year, whereas Liwen ablation had fewer conduction abnormalities, shorter procedure duration, and shorter hospital stay. These findings highlight a clinically relevant trade-off between more complete hemodynamic relief and lower conduction-system injury and require prospective confirmation.\n\nClinical PerspectiveWhat Is New? In a single-center retrospective cohort of 133 patients with symptomatic obstructive hypertrophic cardiomyopathy, modified Morrow myectomy achieved more complete 1-year left ventricular outflow tract gradient reduction (residual gradient, 1.3 vs 16.1 mmHg), whereas Liwen ablation was associated with markedly fewer new conduction abnormalities (5% vs 62%) and no permanent pacemaker implantations.\n\nWhat Are the Clinical Implications? These findings highlight distinct procedural trade-offs and support individualized treatment selection based on anatomy, baseline conduction status, procedural risk, local expertise, and patient preferences; prospective multicenter studies with concurrent enrollment are needed to confirm these comparative associations.",
  "abstract_shown": true,
  "affiliations": [
    "Wuhan Asia Heart Hospital"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "J. Jiao"
    },
    {
      "name": "Y. Long"
    },
    {
      "name": "Z. Yu"
    },
    {
      "name": "Q. Fan"
    },
    {
      "name": "R. Zhou"
    },
    {
      "affs": [
        0
      ],
      "name": "M. Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bjphb7evyyk0g.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.15.26363181",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363181v1.full",
  "id": "bjphb7evyyk0g",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363181v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "cardiovascular medicine"
    ],
    [
      "openalex",
      "2705|Cardiomyopathy and Myosin Studies"
    ]
  ],
  "openalex": "W7213558796",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363181v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bjphb7evyyk0g.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:50Z",
      "native_id": "10.64898/2026.09.15.26363181",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.15.26363181v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:cardiovascular medicine",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Liwen Ablation versus Modified Morrow Myectomy for Obstructive Hypertrophic Cardiomyopathy: 1-Year Hemodynamic and Conduction Outcomes",
  "title_text": "Liwen Ablation versus Modified Morrow Myectomy for Obstructive Hypertrophic Cardiomyopathy: 1-Year Hemodynamic and Conduction Outcomes",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:50Z",
  "url": "https://research.draconitic.com/paper/bjphb7evyyk0g",
  "venue": "medRxiv",
  "versions": []
}