Synergistic effect of dual chamber pacing and disopyramide in obstructive hypertrophic cardiomyopathy.
This study examines acute effect of dual-chamber (DDD) pacing combined with disopyramide for left ventricular outflow tract (LVOT) gradient reduction in obstructive hypertrophic cardiomyopathy (HCM) patients. Among 24 patients refractory to maximal drug therapy, 7 had a significant improvement of LVOT gradient by DDD pacing alone. In the remaining 17 patients, the LVOT gradient reduction was 26+/-19% after DDD pacing alone and 35+/-16% after intravenous disopyramide alone. In contrast, after the combined therapy of DDD pacing and disopyramide, pressure gradient decreased from 102+/-35 to 28+/-23 mm Hg, a reduction of 72+/-21%. We have demonstrated synergy between DDD pacing and disopyramide for LVOT gradient reduction in obstructive HCM. Study of the long-term effects of this combined therapy would be the next step to ascertain clinical utility.
Minami
Yuichiro
Y
Kajimoto
Katsuya
K
Kawana
Masatoshi
M
Hagiwara
Nobuhisa
N
Sherrid
Mark V
MV
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000628:therapy*; D003131:Combined Modality Therapy; D004206:Disopyramide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014694:Ventricular Outflow Obstruction / Q000628:therapy*
D000889:Anti-Arrhythmia Agents; D004206:Disopyramide