Acute decompensation of hypertrophic obstructive cardiomyopathy secondary to A-V disassociation: successful treatment with a combination of alcohol septal ablation and permanent pacemaker.
Alcohol septal ablation is increasingly being offered as a therapy for patients with hypertrophic obstructive cardiomyopathy. The procedure is most often performed in stable patients with a history of increasing symptoms. We describe a patient with hypertrophic obstructive cardiomyopathy with an acute decompensation secondary to the development of complete heart block. The patient's hemodynamics demonstrates the importance of atrial-ventricular (A-V) synchrony in this disease process. This case report is also a unique description of alcohol septal ablation being performed emergently to improve hemodynamics and the urgent implantation of a permanent pacemaker to return A-V synchrony.
Rohatgi
Sameer
S
Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Wiegers
Susan E
SE
Hsia
Henry
H
Herling
Irving
I
Herrmann
Howard C
HC
D000208:Acute Disease; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy; D004452:Echocardiography; D004562:Electrocardiography; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006327:Heart Block / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000628:therapy; D010138:Pacemaker, Artificial
D000891:Anti-Infective Agents, Local; D000431:Ethanol