Author/Editor		Černe, Andreja; Zupan, Igor; Ramovž, Andrej
Title		Urgentna elektrostimulacija srca pri bolnici z obstrukcijo v iztočnem traktu levega prekata
Translated title		Urgent heart electrostimulation with a female patient suffering from left ventricular outflow tract obstruction
Type		članek
Source		In: Križman I, editor. Interna medicina 2006: novosti in aktualnosti. Zbornik predavanj strokovnega sestanka Združenja internistov SZD, 2006 sep 29-30; Ljubljana. Ljubljana: Združenje internistov SZD,
Publication year		2006
Volume		str. 221-5
Language		slo
Abstract		Dual-chamber sequentional pacing (DDD) with a short atrioventricular (AV) delay has emerged as a novel therapeutic approach in left ventricular outflow tract (LVOT) obstruction. We present a case of a 65-year-old woman with LVOT obstruction and concomitant complete AV block. Ultrasound echocardiography showed asymmetric septal hypertrophy, systolic anterior motion of the mitral valve and moderate mitral regurgitation. Her LVOT pressure gradient (PG) measured using continuous wave Doppler recording was 90 mmHg. Due to complete AV block the implantation of permanent DDDR pacemaker was indicated. A short AV delay was set. Significant reduction in LVOT obstruction was demonstrated after 48 hours (PG = 20 mmHg) and almost complete restoration of gradient in LV outflow tract was shown immediately after the DDDR was turned off (PG = 61 mmHg). The echocardiogram also showed disappearance of the systolic anterior motion of the mitral valve and significant regression of the mitral regurgitation. In conclusion, AV synchronous pacing effectively relieved symptoms and reduced pressure gradient in LVOT in patient with LVOT obstruction and concomitant complete AV block.
Descriptors		VENTRICULAR OUTFLOW OBSTRUCTION HEART BLOCK CARDIAC PACING, ARTIFICIAL AGED