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12:03
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Myocardial ischemia with left ventricular outflow obstruction
Aron F Popov1, Christian Bireta, Jan D Schmitto
1Department of Thoracic and Cardiovascular Surgery, University of Göttingen, Germany. Popov@med.uni-goettingen.de
Journal of Cardiothoracic Surgery
|September 19, 2009
Summary
A patient with hypertrophic obstructive cardiomyopathy (HOCM) developed ventricular fibrillation due to myocardial bridging of the left anterior descending artery (LAD). This rare case highlights potential ischemia links to artery compression or pacing-induced diastolic dysfunction.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Interventional Cardiology
Background:
- A 32-year-old male patient with a history of hypertrophic obstructive cardiomyopathy (HOCM) was managed with DDD pacing and short atrioventricular (AV) delay.
- Short AV delays in pacing can sometimes lead to diastolic dysfunction, potentially impacting myocardial perfusion.
Observation:
- The patient unexpectedly experienced ventricular fibrillation without preceding symptoms.
- An invasive cardiac diagnostic procedure was performed following the event.
Findings:
- Cardiac diagnostics revealed a significant myocardial bridging anomaly encircling the left anterior descending artery (LAD).
- The findings suggest potential myocardial ischemia as the cause of ventricular fibrillation.
Implications:
- This case highlights a potential link between myocardial bridging of the LAD and ventricular arrhythmias.
- Ischemia may arise from mechanical compression of the LAD by the myocardial bridge or from altered myocardial perfusion due to the pacing strategy and associated diastolic dysfunction.
- Further investigation is warranted to understand the interplay between structural anomalies, pacing parameters, and arrhythmogenesis in HOCM patients.
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