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Updated: Jun 27, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Synergistic effect of dual chamber pacing and disopyramide in obstructive hypertrophic cardiomyopathy

Yuichiro Minami, Katsuya Kajimoto, Masatoshi Kawana

    International Journal of Cardiology
    |December 23, 2008
    PubMed

    Insights

    Dual-chamber (DDD) pacing combined with disopyramide offers a synergistic approach to reduce left ventricular outflow tract (LVOT) gradients in obstructive hypertrophic cardiomyopathy (HCM) patients refractory to other treatments.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Pharmacology

    Background:

    • Obstructive hypertrophic cardiomyopathy (HCM) presents a significant clinical challenge, often requiring multifaceted treatment strategies.
    • Left ventricular outflow tract (LVOT) obstruction is a hallmark of obstructive HCM, leading to symptoms and adverse outcomes.
    • Current therapeutic options for drug-refractory obstructive HCM are limited, necessitating novel approaches.

    Discussion:

    • This study investigated the acute efficacy of combining dual-chamber (DDD) pacing with intravenous disopyramide for LVOT gradient reduction in obstructive HCM.
    • A significant synergistic effect was observed with the combined therapy, achieving a substantial decrease in LVOT pressure gradient.
    • Individual therapies (DDD pacing or disopyramide) showed some benefit, but the combination yielded superior results.

    Key Insights:

    • Combined DDD pacing and disopyramide therapy demonstrated a potent synergistic effect in reducing LVOT gradients in obstructive HCM patients.
    • The combination therapy reduced the pressure gradient by 72% (from 102+/-35 to 28+/-23 mm Hg) in patients refractory to maximal drug therapy.
    • DDD pacing alone improved gradients in 7 out of 24 patients, while the remaining 17 showed further significant reduction with the addition of disopyramide.

    Outlook:

    • Further research is warranted to evaluate the long-term efficacy and clinical utility of this combined therapeutic strategy.
    • Investigating the optimal parameters for DDD pacing in conjunction with disopyramide may enhance treatment outcomes.
    • This synergistic approach holds promise as a potential therapeutic option for managing drug-refractory obstructive HCM.

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