These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


PUBMED FOR HANDHELDS

Search MEDLINE/PubMed


  • Title: [The treatment of hypertrophic obstructive cardiomyopathy refractory to medical treatment by DDD pacing].
    Author: Tascón J, Albarrán A, Pérez-Carasa MA, Andreu J, Rodríguez J, Coma R, Cosío FG.
    Journal: Rev Esp Cardiol; 1994 May; 47(5):294-302. PubMed ID: 8016438.
    Abstract:
    INTRODUCTION AND OBJECTIVES: In spite of medical treatment, 10% of patients with hypertrophic obstructive cardiomyopathy remain symptomatic, needing surgical treatment. Recent evidence suggests that sequential atrio-ventricular pacing may improve the hemodynamic and clinical situation. PATIENTS AND METHODS: We studied 10 patients with hypertropic obstructive cardiomyopathy (6 women), aged 37-76 years (X = 62 +/- 12) with dyspnea and/or angina, in functional class IV (7) or III (3) of the New York Heart Association. Hemodynamic study was performed basaly and during atrio-ventricular pacing with atrio-ventricular intervals ranging from 75% of basal PR to 50 ms. A DDD pacemaker was implanted in 9 cases, the remainder was treated surgically. RESULTS: The pressure gradient was reduced from 105 +/- 32 to 40 +/- 35 mmHg (p < 0.001); end-diastolic left ventricular pressure fell from 22 +/- 4 to 13 +/- 8 mmHg (p < 0.01), systolic aortic pressure rose from 107 +/- 24 to 125 +/- 13 mmHg (p < 0.05) and cardiac output increased from 3.6 +/- 1.1 to 4.1 +/- 0.81/m (p < 0.05). Mitral insufficiency decreased in 5 of 6 cases, notably in 2 improving from 4+ to 1+. After 1-20 months (X = 10 +/- 6) the 9 patients treated with a permanent DDD pacemaker are in functional class I (7 cases) or II (2 cases). CONCLUSIONS: Atrio-ventricular pacing hypertrophic obstructive cardiomyopathy reduces the systolic gradient and left ventricular end-diastolic pressure with an increase in cardiac output and aortic pressure and improves mitral insufficiency. Short-mid term follow up shows sustained clinical improvement. Optimal atrio-ventricular interval should be individualized.
    [Abstract] [Full Text] [Related] [New Search]