title: Improved hypertrophic obstructive cardiomyopathy by left ventricular apex epicardial pacing.
abstract: We report a case of severe hypertrophic obstructive cardiomyopahy (HOCM) that was markedly improved by left ventricular (LV) apex epicardial pacing. A 55-year-old woman with HOCM had suffered from dyspnea. Cardiac catheter examination showed a resting pressure gradient across the LV outflow tract of 198 mmHg despite combined medication. During the examination, right dual-chamber pacing could not sufficiently reduce the pressure gradient. Therefore, we treated the patient with LV apex epicardial pacing. The procedure decreased the pressure gradient to 10 mmHg. Clinical symptoms were markedly improved. LV apex epicardial pacing may be an alternative therapy for patients with HOCM who are refractory to other medical treatment.
authors.affiliation: Department of Internal Medicine I, School of Medicine, Oita Medical University, Oita.
authors.forename: Kunio
authors.initials: K
authors.lastname: Yufu
authors.forename: Naohiko
authors.initials: N
authors.lastname: Takahashi
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Ooie
authors.forename: Sakuji
authors.initials: S
authors.lastname: Shigematsu
authors.forename: Masahide
authors.initials: M
authors.lastname: Hara
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sako
authors.forename: Shinji
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hadama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Honda
authors.forename: Hironobu
authors.initials: H
authors.lastname: Yoshimatsu
authors.forename: Tetsunori
authors.initials: T
authors.lastname: Saikawa
mesh_terms: D001011:Aorta / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008875:Middle Aged; D016277:Ventricular Function, Left; D017725:Ventricular Pressure