[Percutaneous transluminal septal myocardial ablation combined with permanent dual-chamber pacing in hypertrophic obstructive cardiomyopathy: a case report].
A 74-year-old woman suffering from dyspnea on effort and chest pain (New York Heart Association functional class III) was admitted to our hospital. Echocardiography and left ventriculography showed severe hypertrophy of the left ventricular wall and a severe intraventricular pressure gradient of about 150 mmHg. The diagnosis was hypertrophic obstructive cardiomyopathy. The intraventricular pressure gradient was decreased from 157 to 68 mmHg by percutaneous transluminal septal myocardial ablation (PTSMA), but this reduction was not adequate. Thereafter, dual-chamber pacing was additionally performed. The intraventricular pressure gradient was decreased to 26 mmHg with no complication. PTSMA is a certain way to decrease pressure gradient, but has some complications. Permanent dual-chamber pacing also can show the same effect, but is inferior to PTSMA. Combination of these 2 methods succeeded in abolishing the intraventricular pressure gradient with no complication.
Ochiai
N
N
Department of Cardiology, Saiseikai Kyoto Hospital, Kyoto.
Furukawa
K
K
Ebizawa
T
T
Yagi
T
T
Akashi
K
K
Azuma
A
A
Nakagawa
M
M
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006801:Humans