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Electromechanical left ventricular behavior after nonsurgical septal reduction in patients with hypertrophic obstructive cardiomyopathy

^a Royal Brompton Hospital, London, United Kingdom

View larger version (26K): [in a new window]   Figure 1 M-mode recording of LV septal long axis from a patient with HOCM before (left) and after (right) septal reduction along with ECG and phonocardiogram. Vertical line marks A2, second heart sound. Note the reduction of total amplitude of septal excursion and the marked postejection shortening (arrow) occurring during early diastole associating the development of RBBB. ECG = electrocardiogram; HOCM = hypertrophic obstructive cardiomyopathy; LV = left ventricular; RBBB = right bundle branch block.

View larger version (95K): [in a new window]   Figure 2 Electrocardiogram anterolateral chest leads from the same patient before (above) and after (below) septal reduction. Note the following changes after procedure: development of RBBB, fall of R-wave amplitude in V1 and loss of septal q-wave (arrows). RBBB = right bundle branch block.