Radiofrequency Catheter Ablation of the Accessory Pathway Adversely Affected the Left Ventricular Outflow Tract Pressure Gradient in a Patient With Hypertrophic Obstructive Cardiomyopathy
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概要
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Although hypertrophic cardiomyopathy (HCM) with an accessory pathway is encountered in clinical practice, there is little evidence of a coherent strategy for ablation of the accessory pathway in patients with HCM. We present the case of a 61-year-old man who had type B Wolff-Parkinson-White (WPW) syndrome with hypertrophic obstructive cardiomyopathy (HOCM). Due to paroxysmal atrial fibrillation, he underwent radiofrequency catheter ablation of the accessory pathway located in the right postero-lateral wall to prevent secondary symptomatic events. His LV dyssynchrony improved after the procedure, but the degree of the LV outflow tract (LVOT) pressure gradient was increased. To stabilize the LVOT pressure gradient, he needed additional medications. This case shows that patients with HOCM should be carefully evaluated before making a decision concerning ablation of the accessory pathway.
著者
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Takahashi Masao
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Ando Jiro
Department Of Cardiology The University Of Tokyo
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Imai Yasushi
Department Of Cardiovascular Medicine Graduate School Of Medicine The University Of Tokyo
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Sugiyama Hiroaki
Department of Cardiology, the Cardiovascular Institute Hospital
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Hirata Yasunobu
Department Of Advanced Clinical Science And Therapeutics Cardiovascular Medicine Graduate School Of
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Fujiu Katsuhito
Department Of Cardiology The University Of Tokyo
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Nakayama Atsuko
Department Of Chemistry Tokyo Institute Of Technology
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Nagai Ryozo
Department Cardiovascular Medicine The University Of Tokyo Hospital
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KOJIMA Toshiya
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Hina Kazuyoshi
Okayama Heart Clinic
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