Effect of biventricular pacing on left ventricular outflow tract pressure gradient in a patient with hypertrophic cardiomyopathy and normal interventricular conduction.
We report a case of hypertrophic obstructive cardiomyopathy (HOCM) that was markedly improved by biventricular pacing. A 55-year-old woman with HOCM presented with palpitation and presyncope. Electrophysiologic study revealed an atrioventricular nodal reentrant tachycardia. After radiofrequency catheter ablation, a Mobitz type II atrioventricular block developed and a permanent pacemaker implantation was decided. Cardiac catheterization showed a left ventricular outflow tract (LVOT) gradient of 130 mmHg. Right dual-chamber and atrial-synchronous left ventricular epicardial pacing failed to reduce the gradient. After biventricular pacing, LVOT gradient decreased to 20 mmHg. Biventricular pacing may be an alternative therapy for patients with HOCM.
Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
Baki
B
Komsuoglu
Ahmet
A
Vural
Ayşen
A
Agacdiken
Dilek
D
Ural
D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery; D016277:Ventricular Function, Left / Q000502:physiology*