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Pacing in distal left ventricular hypertrophic cardiomyopathy
F Hintringer1, H J Nesser, J Niel
1Krankenhaus der Elisabethinen, Linz, Austria.
Pacing and Clinical Electrophysiology : PACE
|September 23, 1998
Summary
Permanent dual chamber pacing effectively treated an 85-year-old woman with distal left ventricular (LV) hypertrophy causing an intraventricular pressure gradient and incomplete emptying. This suggests DDD pacing may benefit symptomatic patients with similar rare hypertrophic cardiomyopathy forms unresponsive to medication.
Area of Science:
- Cardiology
- Medical Devices
- Hypertrophic Cardiomyopathy
Background:
- Distal left ventricular (LV) hypertrophy can cause significant intraventricular pressure gradients and incomplete systolic emptying.
- Pharmacological therapy is often insufficient for symptomatic relief in such cases.
- Dual chamber pacing is a potential therapeutic option for specific cardiac conditions.
Observation:
- An 85-year-old woman presented with symptoms attributed to distal LV hypertrophy.
- The patient experienced an intraventricular pressure gradient and incomplete LV systolic emptying.
- Standard pharmacological treatments did not yield satisfactory results.
Findings:
- Permanent DDD pacing was implemented in the patient.
- The patient demonstrated significant clinical benefit following the implantation of the DDD pacemaker.
- This intervention successfully managed the intraventricular pressure gradient and improved LV emptying.
Implications:
- Permanent dual chamber pacing may represent a safe and effective therapeutic strategy for symptomatic patients with rare forms of hypertrophic cardiomyopathy involving mid-ventricular obstruction.
- This approach could be particularly valuable for patients who do not respond adequately to pharmacological therapies.
- Further research into DDD pacing for specific hypertrophic cardiomyopathy subtypes is warranted to confirm these findings.