DUAL CHAMBER PACING FOR LV OUTFLOW OBSTRUCTION IN HYPERTROPHIC CARDIOMYOPATHY

肥厚型心肌病是最重要的遗传性心脏病 疾病。其特点是左侧室壁明显增厚。 心脏的心室(LV)。在大约25%的患者中，这一结果 阻碍血液从左心室流出。这通常是 伴随着严重的症状，如胸痛、呼吸急促、 心悸、头晕、神志不清和疲劳。传统上， 梗阻性肥厚型心肌病患者 从药物治疗中受益的人已经提供了心脏手术来缓解 流出道梗阻。然而，这是一项重大的任务， 与大约5%的手术死亡率有关，并且显著 发病率。双腔起搏，通过改变心脏收缩模式 LV有可能打开LV流出道。在这项研究中 44例梗阻性肥厚型心肌病患者 有严重症状的药物治疗失败的患者接受双重治疗 腔内永久起搏器。这导致了明显的缓解 大多数患者的症状与左室流出量减少有关 障碍物。重要的是，长期双重政策的有利影响 当起搏急剧停止时，房间起搏仍在继续，这表明 慢性起搏导致细胞/分子的继发性改变 水平。

Hypertrophic cardiomyopathy is the most important inherited heart disease. It is characterized by markedly thickened walls of the left ventricle (LV) of the heart. In about 25% of the patients this results in obstruction to the flow of blood out of the LV. This is often associated with severe symptoms such as chest pain, shortness of breath, palpitations, dizziness, blackouts, and fatigue. Traditionally, patients with obstructive hypertrophic cardiomyopathy who have failed to benefit from drug therapy have been offered cardiac surgery to relieve the outflow tract obstruction. However, this is a major undertaking and is associated with about 5% operative mortality and significant morbidity. Dual chamber pacing, by altering the contraction pattern of the LV has the potential to open up the LV outflow tract. In this study 44 consecutive patients with obstructive hypertrophic cardiomyopathy and with severe symptoms who had failed drug therapy were treated with dual chamber permanent pacemaker. This resulted in marked alleviation of symptoms in most patients associated with a reduction in the LV outflow obstruction. Importantly, the favorable effects of long term dual chamber pacing persisted when pacing was acutely discontinued suggesting that chronic pacing results in secondary changes at a cellular/molecular level.