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Biventricular pacing in hypertrophic obstructive cardiomyopathy: a pilot study.
Antonio Berruezo1, Radu Vatasescu, Lluis Mont
1Cardiology Department, Thorax Institute, Hospital Clinic, Barcelona, Spain. berruezo@clinic.ub.es
Heart Rhythm
|October 19, 2010
Summary
Biventricular pacing is a feasible and effective treatment for hypertrophic obstructive cardiomyopathy (HOCM), significantly reducing left ventricular (LV) obstruction and improving patient quality of life. This approach also leads to a reduction in LV mass over time.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Conflicting results exist regarding right ventricular apex pacing for gradient reduction in hypertrophic obstructive cardiomyopathy (HOCM).
- Severe left ventricular (LV) obstruction in HOCM necessitates effective treatment strategies.
Purpose of the Study:
- To assess the feasibility and effectiveness of biventricular pacing in patients with HOCM.
- To evaluate the impact of biventricular pacing on LV obstruction and patient outcomes.
Main Methods:
- Transvenous biventricular pacing was attempted in 12 severely symptomatic HOCM patients.
- Echocardiography was used to assess LV pressure gradient and synchrony.
- Optimal pacing intervals were programmed post-implantation.
Main Results:
- Biventricular pacing was successfully implanted in 9 patients, with biventricular pacing being the optimal mode in 6.
- Significant improvements were observed in functional capacity (NYHA class, 6-minute walk test) and quality of life.
- Progressive reduction in LV gradient and LV mass was noted, alongside changes in LV septal and lateral wall displacement.
Conclusions:
- Biventricular pacing is a feasible and often optimal configuration for reducing gradients in HOCM.
- Biventricular pacing effectively reduces LV hypertrophy and improves clinical outcomes in HOCM patients.
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