To assess the efficacy Liwen procedure in the treatment of complete right bundle branch block (RBBB) in a hypertrophic cardiomyopathy (HCM) patient to provide a new treatment for such patients.

We retrospectively analyzed the clinical data of an HCM patient who was treated by Liwen procedure on September 2017 at the Hypertrophic Cardiomyopathy Center of Xijing Hospital of Air Force Military Medical University. During 2 years of follow-up, the interventricular septum (IVS) thickness and left ventricular outflow tract (LVOT) peak gradient were measured by transthoracic echocardiography, stress-induced gradient and total exercise time were measured by stress echocardiography, cardiac electrical activity was monitored by a 12-lead electrocardiogram, and myocardial fibrosis and ablation area were examined by cardiac magnetic resonance.

At the 2-year follow-up, the patient showed significant reductions in peak LVOT gradients (resting gradient: from 130 mmHg to 8 mmHg; stress-induced gradient: from 181 mmHg to 28 mmHg) and IVS thickness (anterior IVS: from 15 mm to 8 mm; posterior IVS: from 16 mm to 8 mm). The reductions in IVS thickness and LVOT gradients were associated with improvements in the New York Heart Association class (from 3 to 1) and total exercise time (from 6 min to 8 min). Pre-procedure ECG indicated the presence of RBBB, which disappeared from 6 months after Liwen procedure.

Liwen procedure is a new technique which can effectively relieve LVOT obstruction and cause good cardiac outcome.