Effect of biventricular pacing on symptoms and cardiac remodelling in patients with end-stage hypertrophic cardiomyopathy.

Abstract

BACKGROUND:

Biventricular (BiV) pacing is an established therapy for heart failure in ischaemic and dilated cardiomyopathy. Its effects in end-stage hypertrophic cardiomyopathy (HCM) are unknown.

AIMS:

To assess the potential benefits of BiV pacing in patients with symptomatic end-stage HCM.

METHODS:

Twenty patients with non-obstructive HCM (12 male, mean age 57+/-13 years), left bundle branch block and symptoms of heart failure refractory to medical therapy underwent implantation of a BiV device. NYHA class, echocardiographic parameters and exercise capacity were assessed before and after implantation.

RESULTS:

At a mean follow-up of 13+/-6 months, an improvement of at least one NYHA class was reported in 8 (40%) patients. A clinical response was associated with an increase in ejection fraction (from 41+/-14% to 50+/-12%, p=0.009), and reductions in left ventricular end-diastolic diameter (from 57+/-6 mm to 52+/-7 mm, p=0.031) and left atrial diameter (from 65+/-8 mm to 57+/-6 mm, p=0.005). Percentage predicted peak oxygen consumption was unchanged in responders but significantly declined in non-responders (p=0.029).

CONCLUSIONS:

BiV pacing improved heart failure symptoms in a significant proportion of patients with end-stage HCM. Symptomatic improvement was associated with reverse remodelling of the left atrium and ventricle.

• Authors: Dominic P S Rogers, Stefania Marazia, Anthony W Chow, Pier D Lambiase, Martin D Lowe, Michael Frenneaux, William J McKenna, Perry M Elliott
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 10 Issue 5 Pg. 507-13 (May 2008) ISSN: 1388-9842 [Print] England
• PMID: 18406204 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Bundle-Branch Block (therapy)
• Cardiac Pacing, Artificial
• Cardiomyopathy, Hypertrophic (diagnostic imaging, physiopathology, therapy)
• Female
• Heart Failure (diagnostic imaging, physiopathology, therapy)
• Humans
• Male
• Middle Aged
• Pilot Projects
• Ultrasonography
• Ventricular Remodeling (physiology)