Key result
Right ventricular apical pacing with a short AV interval reduced the maximum LVOT pressure gradient from 117 mmHg to 21 mmHg and improved symptoms over 1 year.
Why the study?
Does right ventricular apical pacing with short AV interval improve LVOT gradient and symptoms in a patient with hypertrophic obstructive cardiomyopathy?
Case Report (n=1)
No
Does right ventricular apical pacing with short AV interval improve LVOT gradient and symptoms in a patient with hypertrophic obstructive cardiomyopathy?
Right ventricular apical pacing with a short AV interval may significantly reduce LVOT gradient and improve symptoms in patients with hypertrophic obstructive cardiomyopathy.
Answers are grounded in this paper and cite their sources.
Should not yet change practice in obstructive HCM; leaves open need for randomized trials of RV apical pacing.
Sixty-nine years old lady presented with sudden cardiac arrest, she was found to have hypertrophic obstructive cardiomyopathy, she refused septal myomectomy and had a dual chamber ICD implanted, she was put on right ventricular apical pacing with short AV interval, after pacing her max pressure gradient across left ventricular out flow tract (LVOT) dropped from 117 mmHg to 21 mmHg and her symptoms much improved over a follow up period of 1 year.
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Zaidi et al. (2009) conducted a case report in Hypertrophic obstructive cardiomyopathy (n=1). Right ventricular apical pacing with short AV interval vs. Baseline was evaluated on Max pressure gradient across left ventricular outflow tract (LVOT). Right ventricular apical pacing with a short AV interval reduced the maximum LVOT pressure gradient from 117 mmHg to 21 mmHg and improved symptoms over 1 year.
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