Dual-chamber pacing in hypertrophic obstructive cardiomyopathy: a comparison of acute and chronic effects
| Autor: | Takahide Ito, Yasuhiko Sakai, Yoshihide Kawakami, Tomoshige Morimoto, Yuzo Hirota, Satoshi Shimada, Shinjiro Sasaki, Yasuhisa Nishimoto, Yasunobu Tokaji, Michihiro Suwa, Keishiro Kawamura |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiac output Heart disease Physiology Cardiomyopathy Hemodynamics Doppler echocardiography Muscle hypertrophy Internal medicine Mitral valve medicine Ventricular outflow tract Humans Cardiac Output Aged medicine.diagnostic_test business.industry Cardiac Pacing Artificial Prostheses and Implants Cardiomyopathy Hypertrophic Middle Aged medicine.disease Echocardiography Doppler medicine.anatomical_structure Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Japanese circulation journal. 63(12) |
| ISSN: | 0047-1828 |
| Popis: | This study describes the acute and chronic effects of dual-chamber (DDD) pacing in 14 consecutive patients with hypertrophic obstructive cardiomyopathy (HOCM), whose symptoms were refractory to drug therapy. Although left ventricular (LV) outflow tract pressure gradients diminished from 106+/-47 to 62+/-33 mm Hg (p0.001) by temporary pacing, the residual pressure gradients were30 mm Hg in the majority of those with concomitant reductions in cardiac output. The DDD pacing was judged as insufficient by the acute study in the majority of patients. A dual-chamber pacemaker was, however, implanted in 11 patients, and the chronic pacing effects were evaluated. All symptoms (syncope, fainting, palpitation and dyspnea) subsided within 1 month. Left ventricular outflow tract pressure gradients diminished from 99+/-56 to 21+/-13 mm Hg (p0.004) at 1 week after, and to 17+/-12 mm Hg (p0.002) at 1 year after the implantation, as measured by Doppler echocardiography. Echocardiogram showed disappearance of the systolic anterior motion of the mitral valve, and significant regression of the septal hypertrophy (from 18.5+/-4.3 to 15.7+/-4.1 mm, p0.04). There was no significant correlation between the acute and chronic pacing effects in the reduction of the pressure gradients or symptomatic improvement. These results suggest that DDD pacemaker implantation is an effective treatment without any serious risks for patients with drug-refractory HOCM. The chronic-pacing effect in the reduction of the pressure gradient, the regression of hypertrophy and symptomatic improvement cannot be predicted by the assessment of temporary DDD pacing. |
| Databáze: | OpenAIRE |
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