Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2015, 24(1):25-27

Varying left ventricular outflow obstruction due to atriovantricular dyssynchrony in a patient with hypertrophic obstructive cardiomyopathy

Honek J, Veselka J
Department of Cardiology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic

Alcohol septal ablation (ASA) is an established non-surgical treatment of left ventricular outflow tract obstruction in patients with highly symptomatic hypertrophic obstructive cardiomyopathy (HOCM). The most frequent major complication associated with ASA is the mostly self-terminating complete heart block that occurs in 20-50% of patients and requires permanent pacemaker implantation in 9-20% of all ASA patients. We report a case of varying left ventricular outflow gradient due to transient complete heart block in a patient after ASA for HOCM. The hemodynamic study illustrated the importance of atrial systole for left ventricular filling in patients with HOCM and the hemodynamic mechanisms of AV delay optimization by DDD pacing.

Keywords: hypertrophic cardiomyopathy; alcohol septal ablation; atrio-ventricular dyssynchrony; left ventricular outflow obstruction

Published: January 1, 2015  Show citation

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Honek J, Veselka J. Varying left ventricular outflow obstruction due to atriovantricular dyssynchrony in a patient with hypertrophic obstructive cardiomyopathy. Cardiology Letters. 2015;24(1):25-27.
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