PMID- 29121221
OWN - NLM
STAT- MEDLINE
DCOM- 20190603
LR  - 20201216
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Print)
IS  - 1099-5129 (Linking)
VI  - 20
IP  - 10
DP  - 2018 Oct 1
TI  - Short atrioventricular delay pacing therapy in young and old patients with 
      hypertrophic obstructive cardiomyopathy: good long-term results and a low need 
      for reinterventions.
PG  - 1683-1691
LID - 10.1093/europace/eux331 [doi]
AB  - AIMS: Examination of long-term results following different treatments in 
      hypertrophic obstructive cardiomyopathy (HOCM) in a complete geographical cohort. 
      METHODS AND RESULTS: HOCM patients attending during 2002-13 in all 10 hospitals 
      in the West Gotaland Region, Sweden, were identified (n = 251), follow-up 14.4 
      (+/-8.9) years (mean +/- SD), 121 managed medically, 42 treated with myectomy and 88 
      with short atrioventricular (AV) delay pacing as first interventional procedure. 
      Post-intervention follow-up was 12.9 +/- 8.7 years and 12.2 +/- 5.0 years, 
      respectively. Both intervention treatments improved New York Heart Association 
      (NYHA) class and outflow gradients significantly. Patients treated with pacing 
      were older (median age 64 vs. 43 years, P < 0.001). Freedom from disease-related 
      death post-procedure at 5, 10, and 20 years were 93%, 80%, 56% vs. 93%, 93%, 57% 
      in pacing and myectomy groups, respectively (log-rank P = 0.43). Survival after 
      diagnosis was not different in patients just treated conservatively (P = 0.51 
      pacing/conservative; P = 0.39 myectomy/conservative). Reintervention for outflow 
      gradients in patients >/=18 years at procedure occurred in 3.5% in pacing group and 
      15.6% in myectomy group (P = 0.007). Pacing therapy was equally effective in 
      patients aged 13-64 years (n = 44), as in patients >/=65 years (n = 44): resting 
      gradient pre-procedure and at last follow-up were median (IQR) 65 (71) and 12 
      (20) mmHg for <65 year-olds (P < 0.001), and 75 (64) and 14 (38) mmHg, 
      respectively, for >/=65 year-olds (P < 0.001). New York Heart Association class 
      improved significantly in both age ranges to 1.6 +/- 0.6 and 1.8 +/- 0.7, 
      respectively (P < 0.001; P < 0.001). CONCLUSION: Short AV delay pacing provided 
      lasting satisfactory relief of symptoms and outflow obstruction in the majority 
      of patients, with low risk of requiring reintervention. Our findings support the 
      view that pacing therapy should be considered a valid option to treat patients 
      with HOCM.
FAU - Javidgonbadi, Davood
AU  - Javidgonbadi D
AD  - Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska 
      Academy, University of Gothenburg, Bla straket 5B, Gothenburg, Sweden.
FAU - Abdon, Nils-Johan
AU  - Abdon NJ
AD  - Formerly Department of Medicine, Uddevalla Hospital, Fjallvagen 9, Uddevalla, 
      Sweden (retired).
FAU - Andersson, Bert
AU  - Andersson B
AD  - Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska 
      Academy, University of Gothenburg, Bla straket 5B, Gothenburg, Sweden.
FAU - Schaufelberger, Maria
AU  - Schaufelberger M
AD  - Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska 
      Academy, University of Gothenburg, Bla straket 5B, Gothenburg, Sweden.
FAU - Ostman-Smith, Ingegerd
AU  - Ostman-Smith I
AD  - Department of Pediatrics, Institute of Clinical Sciences, Queen Silvia Children's 
      Hospital, Rondvagen 10, Gothenburg, Sweden.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Calcium Channel Blockers)
SB  - IM
MH  - Adolescent
MH  - Adrenergic beta-Antagonists/*therapeutic use
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Calcium Channel Blockers/*therapeutic use
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cardiomyopathy, Hypertrophic/complications/diagnostic 
      imaging/physiopathology/*therapy
MH  - Conservative Treatment/methods
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Sweden
MH  - Treatment Outcome
MH  - *Uterine Myomectomy
MH  - Ventricular Outflow Obstruction/diagnostic imaging/etiology/physiopathology
MH  - Young Adult
PMC - PMC6182309
EDAT- 2017/11/10 06:00
MHDA- 2019/06/04 06:00
PMCR- 2017/11/07
CRDT- 2017/11/10 06:00
PHST- 2017/05/17 00:00 [received]
PHST- 2017/10/23 00:00 [accepted]
PHST- 2017/11/10 06:00 [pubmed]
PHST- 2019/06/04 06:00 [medline]
PHST- 2017/11/10 06:00 [entrez]
PHST- 2017/11/07 00:00 [pmc-release]
AID - 4601742 [pii]
AID - eux331 [pii]
AID - 10.1093/europace/eux331 [doi]
PST - ppublish
SO  - Europace. 2018 Oct 1;20(10):1683-1691. doi: 10.1093/europace/eux331.