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Arrhythmias in hypertrophic obstructive and non-obstructive cardiomyopathy
European Heart Journal
|November 1, 1983
Summary
Surgical myectomy for hypertrophic obstructive cardiomyopathy (HOCM) did not significantly alter complex ventricular arrhythmias. Post-operative monitoring showed similar rates of ventricular tachycardia and pairs in HOCM patients compared to pre-operative assessments.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Hypertrophic cardiomyopathy (HOCM) impacts symptoms and hemodynamics.
- Transaortic subvalvular myectomy offers a better prognosis than medical therapy for HOCM.
- Complex ventricular arrhythmias are known prognostic factors in HOCM.
Purpose of the Study:
- To investigate the impact of surgical myectomy on ventricular arrhythmias in HOCM patients.
- To compare pre-operative and post-operative arrhythmia burden in HOCM.
- To analyze arrhythmia occurrence in hypertrophic non-obstructive cardiomyopathy (HNCM) as a reference.
Main Methods:
- Thirty-one HOCM patients underwent 48-hour ambulatory monitoring pre- and post-surgery.
- Fifteen HNCM patients were also monitored.
- Complex ventricular arrhythmias defined as pairs or non-sustained ventricular tachycardia (VT).
Main Results:
- No significant change in mean hourly ventricular extrasystole counts pre- vs. post-myectomy in HOCM.
- 11 HOCM patients had complex arrhythmias pre-operatively; 13 had them post-operatively.
- HNCM patients showed a low overall frequency of ventricular extrasystoles.
Conclusions:
- Surgical myectomy in HOCM does not appear to reduce the incidence of complex ventricular arrhythmias.
- The occurrence of ventricular pairs and VT remained similar before and after surgery.
- Further research is needed to understand the long-term electrophysiological effects of myectomy.