Recurrent Syncope Episodes and Exercise Intolerance in Hypertrophic Cardiomyopathy Combined with Atrioventricular Conduction Disturbance

Ventricular tachyarrhythmias are common in hypertrophic cardiomyopathy that may lead to syncope and sudden death. Bradyarrhythmia such as atrioventricular conduction disturbance, a relatively rare complication associated with hypertrophic cardiomyopathy, may also cause syncope and sudden death in hypertrophic cardiomyopathy. We report a 28-year old man who was diagnosed as a case of hypertrophic cardiomyopathy presented with syncope and complete heart block. Subsequently, a permanent pacemaker was implanted to the patient.

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Leadless Cardiac Pacemaker as a Novel Intervention Modality for Atrioventricular Conduction Disturbance in Hypertrophic Cardiomyopathy

Journal of Advanced Therapies and Medical Innovation Sciences ◽

10.17987/jatamis.v2i0.358 ◽

2017 ◽

Vol 2 ◽

Author(s):

Henry Sutanto

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Atrioventricular Block ◽

Time Management ◽

Cardiac Pacemaker ◽

Cardiac Pacing ◽

Atrioventricular Conduction ◽

Conduction Disturbance ◽

Cardiac Pacemakers ◽

Jude Medical ◽

Leadless Pacemaker

Atrioventricular conduction disturbance is a common complication of cardiovascular diseases, such as hypertrophic cardiomyopathy. Moreover, the most common form of atrioventricular conduction disturbance is atrioventricular block. Until recently, cardiac pacing was considered to be the most reliable long-time management of atrioventricular block. However, cardiac pacemakers have several limitations and complications. When the first generation of leadless pacemakers was invented in the 1980s, it was multi-component. Nowadays, self-contained or single component leadless pacemakers have been developed and have become popular amongst cardiac electrophysiologists. In particular, in 2013, St. Jude Medical developed a novel design for a cardiac pacemaker called the NanostimTM Leadless Pacemaker. In 2015, Medtronic released a smaller leadless pacemaker called the MicraTM Transcatheter Pacing System.1,2 Although NanostimTM and MicraTM represent state of the art technology; a few studies have documented some of their limitations.3-6 More research is needed to confirm and solve these problems

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Mechanisms and Medical Management of Exercise Intolerance in Hypertrophic Cardiomyopathy

Current Pharmaceutical Design ◽

10.2174/138161282104141204142436 ◽

2014 ◽

Vol 21 (4) ◽

pp. 466-472 ◽

Cited By ~ 5

Author(s):

V. Patel ◽

C.H. Critoph ◽

P.M. Elliott

Keyword(s):

Hypertrophic Cardiomyopathy ◽

Medical Management ◽

Exercise Intolerance

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Hypertrophic cardiomyopathy with paroxysmal atrial fibrillation misdiagnosed as WPW syndrome

International Journal of Arrhythmia ◽

10.1186/s42444-021-00033-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sang-Hoon Seol ◽

Ki-Hun Kim ◽

Jino Park ◽

Yeo-Jeong Song ◽

Dong-Kie Kim ◽

...

Keyword(s):

Atrial Fibrillation ◽

Hypertrophic Cardiomyopathy ◽

Paroxysmal Atrial Fibrillation ◽

Conduction System ◽

Atrioventricular Conduction ◽

Wpw Syndrome ◽

Bypass Tract ◽

Hypertrophied Myocardium

AbstractHypertrophic cardiomyopathy (HCM) is associated with an increased incidence of Wolff–Parkinson–White (WPW) syndrome and atrial fibrillation. However, a delta-like wide QRS can be observed in the hypertrophied myocardium. When considering the rarity of the paraseptal bypass tract (BT), the normal QRS axis suggests a higher possibility of HCM origin. Otherwise, there is no known electrocardiographic clue indicating a wide QRS differentiation between HCM and WPW syndrome. Moreover, the atriofascicular, nodofascicular/ventricular or fasciculoventricular BT should be differentiated. In this case, atrioventricular conduction system incidental injury revealed a wide QRS origin from the HCM, but this method should be avoided except in some selected cases.

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Atrioventricular Conduction Disturbance Characterization in Transcatheter Aortic Valve Implantation With the CoreValve Prosthesis

Circulation Cardiovascular Interventions ◽

10.1161/circinterventions.111.961649 ◽

2011 ◽

Vol 4 (3) ◽

pp. 280-286 ◽

Cited By ~ 57

Author(s):

José M. Rubín ◽

Pablo Avanzas ◽

Raquel del Valle ◽

Alfredo Renilla ◽

Enrique Ríos ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Atrioventricular Conduction ◽

Conduction Disturbance ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

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Atrial tachycardia, atrioventricular conduction disturbance and right heart failure years after removal of a cardiac hydatid cyst

Journal of Integrative Cardiology ◽

10.15761/jic.1000229 ◽

2017 ◽

Vol 3 (5) ◽

Author(s):

Christos – Konstantinos Antoniou ◽

Petros Arsenos ◽

Nikos Apostolopoulos ◽

Polychronis Dilaveris ◽

Skevos Sideris ◽

...

Keyword(s):

Heart Failure ◽

Hydatid Cyst ◽

Atrial Tachycardia ◽

Right Heart Failure ◽

Atrioventricular Conduction ◽

Conduction Disturbance ◽

Right Heart

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Abstract 19346: Peak Oxygen Consumption Predicts Outcome in Hypertrophic Cardiomyopathy

Circulation ◽

10.1161/circ.130.suppl_2.19346 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Carla Contaldi ◽

Raffaella Lombardi ◽

Alessandra Giamundo ◽

Sandro Betocchi

Keyword(s):

Heart Failure ◽

Oxygen Consumption ◽

Hypertrophic Cardiomyopathy ◽

Nyha Class ◽

Left Ventricular ◽

Exercise Intolerance ◽

Peak Oxygen Consumption ◽

Class Iii ◽

Asymptomatic Patients

Introduction: Peak oxygen consumption (VO 2 ) has a strong and independent prognostic value in systolic heart failure; in contrast no data support its prognostic role in hypertrophic cardiomyopathy (HCM). Hypothesis: We assess if peak VO 2 is a long-term predictor of outcome in HCM. Methods: We studied 92 HCM patients (40±15 years). Peak VO 2 was expressed as percentage (%) of the predicted value. Follow up was 76±57 months. The primary composite endpoint (CE) was atrial fibrillation, progression to NYHA class III or IV, myotomy-myectomy (MM), heart transplantation (HT) and cardiac death. An ancillary endpoint (HFE) included markers of heart failure (progression to NYHA class III or IV, MM and HT). Results: At baseline, 62% of patients were asymptomatic, 35% NYHA class II and 3% NYHA class III; 26% had left ventricular outflow tract obstruction. During follow up, 30 patients met CE with 43 events. By multivariate Cox survival analysis, we analyzed 2 models, using the CE, and in turn HFE. For CE, maximal left atrial diameter (LAD) (HR: 1.12; 95% CI: 1.04 to 1.22), maximal wall thickness (MWT) (HR: 0.14; 95% CI: 1.04 to 1.23) and % predicted peak VO 2 (HR: -0.03; 95% CI: 0.95 to 0.99) independently predicted outcome (overall, p<0.0001). For HFE, maximal LAD (HR:0.31; 95% CI: 1.09 to 1.70), MWT (HR: 0.35; 95% CI: 1.08 to 1.84) and % predicted peak VO 2 (HR: -0.06; 95% CI: 0.89 to 0.98) independently predicted outcome (overall, p<0.0001). Only 19% of mildly symptomatic or asymptomatic patients with % predicted peak VO 2 >80% had events, as opposed to 53% of them with % predicted peak VO 2 < 55% (p= 0.04). Event-free survival for both endpoints was significantly lower in patients with % predicted peak VO 2 < 55% as compared to those with it between 55 and 80 and >80% , Figure. Conclusion: In mildly or asymptomatic patients severe exercise intolerance may precede clinical deterioration. In HCM, peak VO 2 provides excellent risk stratification with a high event rate in patients with % predicted value <55%.

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