title: Mid-Term Results of Dual-Chamber Pacing in Children with Hypertrophic Obstructive Cardiomyopathy.
abstract: BACKGROUND: Permanent dual-chambered pacing (DDD) is an alternative to surgical treatment in patients with severe hypertrophic obstructive cardiomyopathy (HOCM) who do not have a satisfactory response to medical treatment. METHODS: Five children with severe HOCM still symptomatic despite medical treatment underwent permanent DDD pacing and were followed for 21 +/- 9.7 months. RESULTS: All patients improved their functional class. Doppler echocardiographic studies showed an early reduction of the left ventricular outflow tract gradient from 66 +/- 40 to 40 +/- 20 mmHg (P < 0.05) and to 30 +/- 11 mmHg (P < 0.05 and NS for comparison with the baseline and the early post-DDD pacing gradients, respectively) at mid-term follow-up. There was no evidence of left ventricular systolic dysfunction, and the results of left ventricular filling studies ruled out deleterious effects on diastolic function. Doppler echocardiography played a key role in the initial and subsequent assessment of these patients. CONCLUSIONS: Permanent DDD pacing is a reasonable alternative to surgery in children with HOCM who are still symptomatic despite medical therapy.
authors.affiliation: Section of Pediatric Cardiology, Hospital Privado, Naciones Unidas 346, 5016 Cordoba, Argentina.
authors.forename: Luis E.
authors.initials: LE
authors.lastname: Alday
authors.forename: Eva
authors.initials: E
authors.lastname: Bruno
authors.forename: Eduardo
authors.initials: E
authors.lastname: Moreyra
authors.forename: Luis M.
authors.initials: LM
authors.lastname: Amuchastegui
authors.forename: Ernesto
authors.initials: E
authors.lastname: Juaneda
authors.forename: Hector
authors.initials: H
authors.lastname: Maisuls