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Sequential Atrioventricular Pacing in Patients With Hypertrophic Cardiomyopathy: An 18-year Experience

Alfonso Jurado Román1, José M Montero Cabezas1, Belén Rubio Alonso1

  • 1Departamento de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.

Revista Espanola De Cardiologia (English Ed.)
|January 1, 2016
PubMed

Insights

Sequential atrioventricular pacing significantly improves symptoms and reduces the dynamic gradient and mitral regurgitation in patients with obstructive hypertrophic cardiomyopathy. Long-term ventricular pacing did not negatively impact cardiac function.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Medicine

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) presents challenges in symptom management.
  • The role of sequential atrioventricular pacing in HCM remains debated.

Purpose of the Study:

  • To evaluate the efficacy of sequential atrioventricular pacing.
  • Assess impact on symptoms, dynamic gradient, and left ventricular function in obstructive HCM patients.

Main Methods:

  • 82 patients with obstructive HCM received dual-chamber pacemakers with short AV delay.
  • Clinical and echocardiographic data collected pre-implantation, post-implantation, and long-term (median 8.5 years).

Main Results:

  • 95% of patients showed immediate functional class improvement, maintained in 89% long-term.
  • Significant reduction in dynamic gradient and mitral regurgitation observed.
  • No adverse effects on ventricular size, ejection fraction, or diastolic function.

Conclusions:

  • Sequential pacing is effective in selected obstructive HCM patients.
  • Improves functional class, reduces gradient and mitral regurgitation long-term.
  • Prolonged pacing does not impair systolic or diastolic function.
Abstract

Keywords:
DiastoleDiástoleHypertrophic cardiomyopathyMarcapasosMiocardiopatía hipertróficaObstrucciónObstructionPacemakersSystoleSístole

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