DDD-R pacemaker implantation in a patient with A-V complete block and hypertrophic obstructive cardiomyopathy

T›bbi tedaviye yan›t vermeyen hipertrofik obstrüktif kardiyomiyopatili (HOKM) hastalar›n tedavisi hala tart›flmal›d›r. Hipertrofik obstrüktif kardiyomiyopatide semptomlar›n patofizyolojisi sol ventrikül ç›k›fl yolu (SVÇY) obstrüksiyonu, diyastolik fonksiyon bozuklu¤u, mitral kapa¤› yetersizli¤i (MY) ve aritmilerden oluflan kompleks bir durumdur. Cerrahi miyotomi-miyektomi, deneyimli merkezlerde uyguland›¤›nda, SVÇY obstrüksiyonunu hafifletmede ve semptomlar› iyilefltirmede etkili ve güvenilir bir yöntemdir. Negatif inotropik ilaçlar etkisiz oldu¤unda ve septal miyotomi ve miyektomi konusunda deneyimli cerrah ve uygun koflullar bulunmad›¤›nda SVÇY obstrüksiyonunu azaltmada iki odac›kl› (DDD) kal›c› pacemaker ve septal koroner arter ve/veya arterlerin embolizasyonu cerrahiye alternatif yöntemler olarak uygulanmaktad›r. Bu grup hastalar›n tedavisini belirlerken yafl, yaflam stili ve cerrahi riski gibi faktörler göz önüne al›nmaktad›r. DDD pacemaker implantasyonunun, seçilmifl hastalarda hemodinamik ve semptomatik iyileflme sa¤lad›¤› gösterilmifltir.

[1]  E. Aliot,et al.  Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy. , 1999, European heart journal.

[2]  J. Daubert,et al.  Effects of permanent dual-chamber pacing on mitral regurgitation in hypertrophic obstructive cardiomyopathy. , 1999, European heart journal.

[3]  A. Tajik,et al.  Dual-chamber pacing for hypertrophic cardiomyopathy: a randomized, double-blind, crossover trial. , 1997, Journal of the American College of Cardiology.

[4]  J. Daubert,et al.  Importance of Atrial Contraction in Hypertrophic Obstructive Cardiomyopathy: Implications for Pacing Therapy , 1996 .

[5]  A. Tajik,et al.  Extent of clinical improvement after surgical treatment of hypertrophic obstructive cardiomyopathy. , 1996, Circulation.

[6]  D Tripodi,et al.  Long‐term Results of Dual‐Chamber (DDD) Pacing in Obstructive Hypertrophic Cardiomyopathy: Evidence for Progressive Symptomatic and Hemodynamic Improvement and Reduction of Left Ventricular Hypertrophy , 1994, Circulation.

[7]  A. Tajik,et al.  The outcome of surgical treatment of hypertrophic obstructive cardiomyopathy. Experience over 15 years. , 1989, The Journal of thoracic and cardiovascular surgery.

[8]  W. Williams,et al.  Results of surgery for hypertrophic obstructive cardiomyopathy. , 1987, Circulation.

[9]  W. Williams,et al.  Hypertrophic cardiomyopathy. The importance of the site and the extent of hypertrophy. A review. , 1985, Progress in cardiovascular diseases.

[10]  B. Gilbert,et al.  Hypertrophic cardiomyopathy: subclassification by m mode echocardiography. , 1980, The American journal of cardiology.

[11]  H. Rakowski,et al.  Muscular subaortic stenosis: the quantitative relationship between systolic anterior motion and the pressure gradient. , 1984, Circulation.