Treatment in Patients with Hypertrophic Obstructive Cardiomyopathy: A New Strategy used in our Hospital and the Results

Objective: In the treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM), the effects of drug therapy using negative inotropic drugs, percutaneous transluminal septal myocardial ablation (PTSMA), DDD pacemakers and surgical myectomy/myotomy are well recognized. In this study, we investigate a new treatment strategy used in our hospital for the last year. Methods: Eight patients diagnosed with HOCM by catheter examinations received a temporary DDD pacemaker, temporary septal branch occlusion, and a disopyramide intravenous infusion. The systolic pressure gradient of the left ventricular outflow tract was measured before and after the provocations, and then we decided which therapy was the best for each patient. Result: Two patients received PTSMA, one received a DDD pacemaker, and five received medical therapy. Three of the medical therapy patients gained a higher LVOTG, and for two of them their therapy was changed to PTSMA. Each of the LVOTGs were reduced to a theraputic level and good results were obtained. Finally, four patients received PTSMA, one received a DDD pacemaker, and three received medical therapy. Conclusion: There may be a difference between internal use and intravenous infusion in the effect of disopyramide. PTSMA was effective for these patients and considered to be an effective therapy for patients with HOCM.