A 53-year-old man diagnosed and treated for hypertrophic obstructive cardiomyopathy received serial echocardiograms before and after dual-chamber pacemaker implantation. Varying the programmed atrioventricular delay in a dual-chamber pacemaker can affect the left ventricular outflow tract pressure gradient in hypertrophic obstructive cardiomyopathy. Serial Doppler echo examinations were used to evaluate the effect of varying atrioventricular intervals. Echocardiography can be effectively used with pacemaker programming to optimize the left ventricular outflow tract velocities in patients with hypertrophic obstructive cardiomyopathy.
1. Goodwin JF: Cardiomyopathies and specific heart muscle diseases. Definitions, terminology, classifications and new and old approaches. Postgrad Med J1992;68(Suppl):3-6.
2.
2. Sokolow M, McIlroy MB, Chetlin MID: Myocardial disease (myocarditis and cardiomyopathy), in Sokolow M (eds): Clinical Cardiology. Fifth edition. Norwalk, Appleton & Lange, 1990, pp 536-581.
3.
3. Nienaber CA, Hiller S, Spielmann RP, et al: Syncope in hypertrophic cardiomyopathy: Multivariate analysis of prognostic determinants. J Am Coll Cardiol1990;15:948-955.
4.
4. McAreavey D, Fananaparzir L: Altered cardiac hemodynamic and electrical state in normal sinus rhythm after chronic dual-chamber pacing for relief of left ventricular outflow obstruction in hypertrophic cardiomyopathy. Am J Cardiol1992;70:651-656.
5.
5. Rishi F, Hulse JE, Sharma S, et al: Temporary dual chamber pacing in pediatric patients with hypertrophic obstructive cardiomyopathy. Circulation1993;88:1-211.
6.
6. Kappenberger L, Jeanrenaud X: Regional wall motion analysis during dual-chamber pacing for hypertrophic obstructive cardiomyopathy. Circulation1993;88:1-211.
7.
7. Slade KB, Keeling PJ, Prasad K, et al: Acute evaluation of DDD versus DDDR mode predicts additional benefit of rate adaptive pacing in hypertrophic cardiomyopathy. J Am Coll Cardiol1994;705-I:10A-10A. Abstract.
8.
8. McAreavey D, Fananpazir L: Acute pacing studies are not valuable in predicting long term benefits of DDD pacing for LV outflow obstruction in hypertrophic cardiomyopathy. J Am Coll Cardiol1994;705-2:10A-10A. Abstract.
9.
9. McAreavey D, Epstein ND, Fananpazir L: Dual chamber pacing is effective therapy for hypertrophic cardiomyopathy patients with provocable LV outflow tract obstruction and symptoms refractory to medical therapy. J Am Coll Cardiol1994;705-3:11A-11A. Abstract.
10.
10. Sasson Z, Henderson M, Wilansky S, et al: Causal relation between the pressure gradient and left ventricular ejection time in hypertrophic cardiomyopathy. J Am CoIl Cardiol1986;13:1275-1279.
11.
11. Simon JP, Sadoul N, Chillou C, et al: Long-term dual chamber pacing improves hemodynamic function in patients with obstructive hypertrophic cardiomyopathy. Circulation1993;88:I-211.
12.
12. McAreavey D, Fananapazir L: Suppression of incessant ventricular tachycardia in hypertrophic cardiomyopathy associated with improvement of severe left ventricular dysfunction. Pace1992;15:1642-1645.
13.
13. Spirito P: Role of cardiac ultrasound in the assessment of hypertrophic cardiomyopathy. Int J Card Imaging1993;2:51-53.
14.
14. Reynolds T. Cardiomyopathies, in Reynolds T (ed): The Echocardiographer's Pocket Reference. Arizona, Arizona Heart Institute Foundation, 1993, pp 61-65.
15.
15. Gross JN, Keltz TN, Cooper JA, et al: Profound “pacemaker syndrome” in hypertrophic cardiomyopathy. Am J Cardiol1992;70:1507-1511.
