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Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation

Treatment of symptom recurrence after initially successful alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy (HOCM) when accompanied by relapse of intracavitary left ventricular pressure gradient (LVG) is guided by the underlying mechanism. We describe our experience with perm...

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Detalles Bibliográficos
Autores principales: Velchev, Vasil, Postadzhiyan, Arman, Hazarbasanov, Dobri, Finkov, Bojidar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303682/
https://www.ncbi.nlm.nih.gov/pubmed/22500235
http://dx.doi.org/10.1155/2012/757501
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author Velchev, Vasil
Postadzhiyan, Arman
Hazarbasanov, Dobri
Finkov, Bojidar
author_facet Velchev, Vasil
Postadzhiyan, Arman
Hazarbasanov, Dobri
Finkov, Bojidar
author_sort Velchev, Vasil
collection PubMed
description Treatment of symptom recurrence after initially successful alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy (HOCM) when accompanied by relapse of intracavitary left ventricular pressure gradient (LVG) is guided by the underlying mechanism. We describe our experience with permanent pacing in three patients with relapse of both LVG and symptoms 7 to 12 months after successful ASA. Even though pressure gradient recurrence was observed at midventricular level, we were able to achieve symptomatic improvement and LVG reduction after right ventricular apex pacing in all three cases. The effect on symptoms was long lasting—the 6-month followup echo-stress tests confirmed good exercise capacity and lack of provocable LVG. We found pacing to be a safe and effective treatment option in this clinical scenario. Based on our overall observations, we propose pacing as a niche treatment for patients with recurrence of LVG at midventricular level after ASA.
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spelling pubmed-33036822012-04-12 Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation Velchev, Vasil Postadzhiyan, Arman Hazarbasanov, Dobri Finkov, Bojidar Int J Vasc Med Research Article Treatment of symptom recurrence after initially successful alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy (HOCM) when accompanied by relapse of intracavitary left ventricular pressure gradient (LVG) is guided by the underlying mechanism. We describe our experience with permanent pacing in three patients with relapse of both LVG and symptoms 7 to 12 months after successful ASA. Even though pressure gradient recurrence was observed at midventricular level, we were able to achieve symptomatic improvement and LVG reduction after right ventricular apex pacing in all three cases. The effect on symptoms was long lasting—the 6-month followup echo-stress tests confirmed good exercise capacity and lack of provocable LVG. We found pacing to be a safe and effective treatment option in this clinical scenario. Based on our overall observations, we propose pacing as a niche treatment for patients with recurrence of LVG at midventricular level after ASA. Hindawi Publishing Corporation 2012 2012-02-19 /pmc/articles/PMC3303682/ /pubmed/22500235 http://dx.doi.org/10.1155/2012/757501 Text en Copyright © 2012 Vasil Velchev et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Velchev, Vasil
Postadzhiyan, Arman
Hazarbasanov, Dobri
Finkov, Bojidar
Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation
title Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation
title_full Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation
title_fullStr Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation
title_full_unstemmed Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation
title_short Permanent Pacing in Patients with Recurrence of Symptoms and Relapse of Left Ventricular Obstruction at Midcavity Level after Alcohol Septal Ablation
title_sort permanent pacing in patients with recurrence of symptoms and relapse of left ventricular obstruction at midcavity level after alcohol septal ablation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303682/
https://www.ncbi.nlm.nih.gov/pubmed/22500235
http://dx.doi.org/10.1155/2012/757501
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