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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
PubMed

Insights

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.
Abstract

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