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Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertrophic obstructive cardiomyopathy¹

A comparison of objective hemodynamic and exercise end points

Steve R. Ommen, MD^*, Rick A. Nishimura, MD, FACC^*, Ray W. Squires, PhD^*, Hartzell V. Schaff, MD, FACC, Gordon K. Danielson, MD, FACC and A. Jamil Tajik, MD, FACC^*

^* Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.

View larger version (12K): [in a new window]   Figure 1 Change in New York Heart Association (NYHA) classification from baseline to follow-up for patients undergoing surgical septal myectomy or dual-chamber (DDD) pacing.

View larger version (22K): [in a new window]   Figure 2 Change in Doppler-derived resting left ventricular outflow tract (LVOT) gradient from baseline to follow-up assessment. Both groups (surgical myectomy, left; dual-chamber pacing, right) show significant reductions in resting gradient (p < 0.05).

View larger version (9K): [in a new window]   Figure 3 Effects of treatment modalities on exercise duration. The surgical myectomy patients show a significant increase (*p < 0.05), whereas the pacing patients do not. Open bars = pretreatment; solid bars = posttreatment.

View larger version (11K): [in a new window]   Figure 4 Effects of treatment modalities on peak oxygen consumption (VO2) in patients treated for symptomatic hypertrophic obstructive cardiomyopathy (*p < 0.05). Open bars = pretreatment; solid bars = posttreatment.