Dual-Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy : A Comparison of Acute and Chronic Effects
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概要
- 論文の詳細を見る
This study describes the acute and chronic effects of dual-chamber(DDD) pacing in 14 consecutive patients with hypertrophic obstructive cardiomyopathy(HOCM), whose symptoms were refractory to drug therapy. Although left ventricular(LV) outflow tract pressure gradients diminished from 106±47 to 62±33 mmHg(p<0.001)by temporary pacing, the residual pressure gradients were >30 mmHg in the majority of those with concomitant reductions in cardiac output. The DDD pacing was judged as insufficient by the acute study in the majority of patients. A dual-chamber pacemaker was, however, implanted in 11 patients, and the chronic pacing effects were evaluated. All symptoms(syncope, fainting, palpitation and dyspnea)subsided within 1 month. Left ventricular outflow tract pressure gradients diminished from 99±56 to 21±13 mmHg(p<0.004)at 1 week after, and to 17±12 mmHg(p<0.002)at 1 year after the implantation, as measured by Doppler echocardiography. Echocardiogram showed disappearance of the systolic anterior motion of the mitral valve, and significant regression of the septal hypertrophy(from 18.5±4.3 to 15.7±4.1 mm, p<0.04). There was no significant correlation between the acute and chronic pacing effects in the reduction of the pressure gradients or symptomatic improvement. These results suggest that DDD pacemaker implantation is an effective treatment without any serious risks for patients with drug-refractory HOCM. The chronic-pacing effect in the reduction of the pressure gradient, the regression of hypertrophy and symptomatic improvement cannot be predicted by the assessment of temporary DDD pacing.
- 社団法人日本循環器学会の論文
- 1999-11-20
著者
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Suwa M
Hokusetsu General Hospital
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ITO Takahide
Third Department of Internal Medicine, Osaka Medical College
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Suwa Michihiro
Third Department of Medicine, Osaka Medical College
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Sakai Yasuhiko
Third Division, Department of Internal Medicine, Osaka Medical College
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Tokaji Yasunobu
Third Division, Department of Internal Medicine, Osaka Medical College
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Ito Takahide
Hayama Heart Center
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Kawamura K
Department Of Internal Medicine (iii) Osaka Medical College
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Kawamura Keishiro
The Third Division Internal Medicine Osaka College
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Hirota Yuzo
The Third Division, Department of Internal Medicine, Osaka Medical College
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Shimada Satoshi
Third Division, Department of Internal Medicine, Osaka Medical College
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Hirota Yuzo
Third Division, Department of Internal Medicine, Osaka Medical College
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Kawakami Yoshihide
Third Division, Department of Internal Medicine, Osaka Medical College
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Kawamura Keishiro
Third Division, Department of Internal Medicine, Osaka Medical College
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Hirota Yuzo
The Third Division Department Of Internal Medicine Osaka Medical College
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Hirota Yuzo
Department Of Thoracic Surgery Osaka Medical College
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Hirota Yuzo
Third Division Department Of Internal Medicine
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Hirota Yuzo
The Third Division Department Of Internal Medicine Osaka Medical College Takatsuki
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Sakai Yasuhiko
Third Division Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
Dept. Of Intern. Med. Osaka Medical Colledge.
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Suwa Michihiro
3rd Division Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
Third Department Of Internal Medicine Osaka Medical College
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Kawakami Yoshihide
Third Division Department Of Internal Medicine Osaka Medical College
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Morimoto Tomoshige
Department Of Thoracic Surgery Osaka Medical College
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Sasaki Shinjiro
Department Of Thoracic And Cardiovascular Surgery
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Kawamura Keishiro
Department Of Internal Medicine (iii) Osaka Medical College
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Sasaki Shinjiro
Department Of Thoracic And Cardiovascular Surgery Osaka Medical College
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Ito Takahide
Third Department Of Internal Medicine Osaka Medical College
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Tokaji Yasunobu
The Third Division Department Of Internal Medicine Osaka Medical College
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Nishimoto Yasuhisa
Department of Thoracic Surgery, Osaka Medical College
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Nishimoto Yasuhisa
Department Of Thoracic Surgery Osaka Medical College
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Nishimoto Yasuhisa
Department Of Thoracic And Cardiovascular Surgery Osaka-fu Mishima Critical Care Medical Center
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Sasaki Shinjiro
Department Of Radiology And Thoracic Surgery. Osaka Medical College
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Sakai Yasuhiko
The Third Division Department Of Internal Medicine Osaka Medical College
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Kawamura Keishiro
Third Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
大阪医科大学
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Sumi Shin-ichiro
Thoracic And Cardiovascular Surgery Osaka Medical College
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Shimada Satoshi
Third Division Department Of Internal Medicine Osaka Medical College
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Sumi Shin-ichiro
Institute For Biotechnology Research Wakunaga Pharmaceutical Co. Itd
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Sasaki Shlnjiro
2nd Div. Dept. Of Surg. Osaka Med. Coll.
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Sasaki Shinjiro
Department Of Thoracic Surgery And Physiology Osaka Medical College
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Kawamura Keishiro
3rd Div. Dept. Intern. Med. Osaka Medical College
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Kawamura Keishiro
3rd Div. Dept. Of Intern. Med. Kyoto Univ. Hosp.
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Kawamura Keishiro
The 3rd Div. Dept.of Int.med. Osaka Medical College
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Sasaki Shinjiro
Department Of Thoraclc Surgery Osaka Medical College
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Katayama Kazuhiro
2nd Dept. Of Internal Med. Yamaguchi University
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Sasaki Shinjiro
Dept. Of Surg. Osaka Med. Coll.
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