Improved hypertrophic obstructive cardiomyopathy by left ventricular apex epicardial pacing.
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.
Yufu
Kunio
K
Department of Internal Medicine I, School of Medicine, Oita Medical University, Oita.
Takahashi
Naohiko
N
Ooie
Tatsuhiko
T
Shigematsu
Sakuji
S
Hara
Masahide
M
Sako
Hidenori
H
Miyamoto
Shinji
S
Hadama
Tetsuo
T
Tsuchiya
Takeshi
T
Honda
Toshihiro
T
Yoshimatsu
Hironobu
H
Saikawa
Tetsunori
T
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