Comparison of Long-Term Effect of Dual-Chamber Pacing and Alcohol Septal Ablation in Patients with Hypertrophic Obstructive Cardiomyopathy

Autoři	KREJČÍ Jan GREGOR Pavel ZEMANEK David VYSKOČILOVÁ Klaudia CURILA Karol STEPANOVA Radka NOVÁK Miroslav GROCH Ladislav VESELKA Josef
Rok publikování	2013
Druh	Článek v odborném periodiku
Časopis / Zdroj	The Scientific World Journal
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
Doi	http://dx.doi.org/10.1155/2013/629650
Obor	Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova	OUTFLOW TRACT OBSTRUCTION; LEFT-VENTRICULAR HYPERTROPHY; FOLLOW-UP; PACEMAKER IMPLANTATION; SUBAORTIC STENOSIS; DOUBLE-BLIND; REDUCTION; CROSSOVER; BENEFITS; THERAPY
Popis	Introduction. Nonpharmacological treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM) comprises surgical myectomy (SME), alcohol septal ablation (ASA), and dual-chamber (DDD) pacing. The aim of the study was to compare the long-term effect of DDD pacing and ASA in symptomatic HOCM patients. Patients and Methods. We evaluated retrospective data from three cardiocenters; there were 24 patients treated with DDD pacing included and 52 treated with ASA followed for 101 +/- 49 and 87 +/- 23 months, respectively. Results. In the group treated with DDD pacing, the left ventricle outflow tract gradient (LVOTG) decreased from 82 +/- 44mmHg to 21 +/- 21mmHg, and NYHA class improved from 2.7 +/- 0.5 to 2.1 +/- 0.6 (both P < 0.001). In the ASA-treated group, a decline in LVOTG from 73 +/- 38mmHg to 24 +/- 26 mmHg and reduction in NYHA class from 2.8 +/- 0.5 to 1.7 +/- 0.8 were observed (both P < 0.001). The LVOTG change was similar in both groups (P = 0.264), and symptoms were more affected by ASA (P = 0.001). Conclusion. ASA and DDD pacing were similarly effective in reducing LVOTG. The symptoms improvement was more expressed in patients treated with ASA.