PMID- 19482844
OWN - NLM
STAT- MEDLINE
DCOM- 20100615
LR  - 20161125
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 96
IP  - 5
DP  - 2010 Mar
TI  - Late benefits of dual-chamber pacing in obstructive hypertrophic cardiomyopathy: 
      a 10-year follow-up study.
PG  - 352-6
LID - 10.1136/hrt.2008.158915 [doi]
AB  - OBJECTIVE: To examine the mid-term and long-term outcomes in patients with 
      obstructive hypertrophic cardiomyopathy (HCM) submitted to pacing. DESIGN: 
      Prospective, observational study. SETTING: Single, non-referral centre. PATIENTS 
      AND INTERVENTION: Fifty patients (62 + or - 11 years) with HCM refractory to 
      medical treatment, all in New York Heart Association (NYHA) class III or IV, and 
      with a rest gradient >50 mm Hg underwent a dual-chamber pacemaker implantation. 
      Patients were followed-up for up to 10 years (mean 5.0 + or - 2.9, range 
      0.6-10.1). RESULTS: During the first year of follow-up, rest gradients decreased 
      (baseline 86 + or - 29 mm Hg; 3 months 55 + or - 37; l year 41 + or - 26; 
      p=0.0001). NYHA class improved, as well as exercise tolerance (baseline 281 + or 
      - 112 m; 3 months 334 + or - 106 m; 1 year 348 + or - 78 m; p<0.0001). The 
      physical and mental components of the quality of life instrument SF-36 also 
      improved. Left ventricular wall thickness remained unchanged, while ejection 
      fraction decreased (baseline 76 + or - 10%; 3 months 74 + or - 8%; 1 year 66 + or 
      - 13%; p=0.002). During the long-term follow-up, an additional reduction in 
      obstruction was found (final rest gradient 28 + or - 24 mm Hg, p<0.02). Those 
      patients who did not improve to NYHA class I or II and continued to have 
      obstruction were given other treatments (six, alcohol ablation; three, surgical 
      myectomy). CONCLUSIONS: Pacing in HCM results in a significant reduction in 
      obstruction, improvement of symptoms and exercise capacity that is progressive 
      and may be achieved after a long period of time. In this series, only 18% of 
      cases needed a more aggressive treatment to relieve residual obstruction and 
      obtain a satisfactory symptomatic status. In conclusion, these results emphasise 
      the need for new controlled studies of pacing with a longer follow-up.
FAU - Galve, Enrique
AU  - Galve E
AD  - Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Pg Vall 
      d'Hebron 119-129, 08035 Barcelona, Spain. egalve@vhebron.net
FAU - Sambola, Antonia
AU  - Sambola A
FAU - Saldana, German
AU  - Saldana G
FAU - Quispe, Ivan
AU  - Quispe I
FAU - Nieto, Elsa
AU  - Nieto E
FAU - Diaz, Anna
AU  - Diaz A
FAU - Evangelista, Arturo
AU  - Evangelista A
FAU - Candell-Riera, Jaume
AU  - Candell-Riera J
LA  - eng
PT  - Journal Article
DEP - 20090528
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/*therapy
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/diagnostic imaging/therapy
MH  - *Pacemaker, Artificial
MH  - Prospective Studies
MH  - Ultrasonography
MH  - Ventricular Outflow Obstruction/diagnostic imaging/therapy
EDAT- 2009/06/02 09:00
MHDA- 2010/06/16 06:00
CRDT- 2009/06/02 09:00
PHST- 2009/06/02 09:00 [entrez]
PHST- 2009/06/02 09:00 [pubmed]
PHST- 2010/06/16 06:00 [medline]
AID - hrt.2008.158915 [pii]
AID - 10.1136/hrt.2008.158915 [doi]
PST - ppublish
SO  - Heart. 2010 Mar;96(5):352-6. doi: 10.1136/hrt.2008.158915. Epub 2009 May 28.