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Morbidity and resource usage after myectomy- or pacing-treatment in hypertrophic obstructive cardiomyopathy: A

Davood Javidgonbadi1, Bert Andersson2, Nils-Johan Abdon3

  • 1Department of Cardiology, Northern Älvsborg County Hospital, Trollhättan, Sweden.

International Journal of Cardiology
|August 24, 2020
PubMed

Insights

Short atrio-ventricular delay pacing offers a safe and cost-effective treatment for hypertrophic obstructive cardiomyopathy (HOCM) compared to myectomy, with fewer complications and re-interventions.

Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Cardiology

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) treatment often involves myectomy or pacing.
  • Long-term morbidity data comparing these HOCM treatments is limited.
  • Short atrio-ventricular delay pacing demonstrates comparable hemodynamic results to myectomy.

Purpose of the Study:

  • To compare the long-term morbidity of short atrio-ventricular delay pacing versus myectomy in HOCM patients.
  • To evaluate complications, re-interventions, hospital stay, and costs associated with each treatment.

Main Methods:

  • Retrospective study of 251 HOCM patients (2002-2013) in West Götaland, Sweden.
  • Case-control methodology matched 31 pairs for age, wall thickness, and LVOT-gradient.
  • Data collected on peri-procedural and long-term outcomes, including complications and costs.

Main Results:

  • Both pacing and myectomy improved NYHA class and LVOT-gradients.
  • Pacing had significantly fewer peri-procedural complications (3.2% vs. 35.5%).
  • Pacing group showed superior freedom from re-interventions (90.3% vs. 61.3%), shorter hospital stays, and lower costs.

Conclusions:

  • Short atrio-ventricular delay pacing is a reliable treatment for drug-refractory HOCM.
  • Pacing presents a lower complication rate and reduced healthcare costs compared to myectomy.
  • Pacing offers a favorable long-term outcome profile for HOCM management.
Abstract

Keywords:
Hypertrophic obstructive cardiomyopathyMyectomyPacingRe-intervention

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