Key result
Biventricular pacing decreased the left ventricular outflow tract gradient from 130 mmHg to 20 mmHg in a patient with hypertrophic obstructive cardiomyopathy.
Why the study?
Does biventricular pacing reduce left ventricular outflow tract pressure gradient in a patient with hypertrophic obstructive cardiomyopathy?
Case Report (n=1)
Does biventricular pacing reduce left ventricular outflow tract pressure gradient in a patient with hypertrophic obstructive cardiomyopathy?
Absolute Event Rate: 20% vs 130%
Biventricular pacing may serve as an effective alternative therapy for reducing LVOT gradient in patients with hypertrophic obstructive cardiomyopathy.
May warrant consideration in refractory cases; hypothesis-generating from one case and requires prospective validation before adoption.
We report a case of hypertrophic obstructive cardiomyopathy (HOCM) that was markedly improved by biventricular pacing. A 55-year-old woman with HOCM presented with palpitation and presyncope. Electrophysiologic study revealed an atrioventricular nodal reentrant tachycardia. After radiofrequency catheter ablation, a Mobitz type II atrioventricular block developed and a permanent pacemaker implantation was decided. Cardiac catheterization showed a left ventricular outflow tract (LVOT) gradient of 130 mmHg. Right dual-chamber and atrial-synchronous left ventricular epicardial pacing failed to reduce the gradient. After biventricular pacing, LVOT gradient decreased to 20 mmHg. Biventricular pacing may be an alternative therapy for patients with HOCM.
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Komşuoğlu et al. (2005) conducted a case report in Hypertrophic obstructive cardiomyopathy (HOCM) (n=1). Biventricular pacing vs. Right dual-chamber and atrial-synchronous left ventricular epicardial pacing (and baseline) was evaluated on Left ventricular outflow tract (LVOT) gradient. Biventricular pacing decreased the left ventricular outflow tract gradient from 130 mmHg to 20 mmHg in a patient with hypertrophic obstructive cardiomyopathy.
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