Rare association of hypertrophic cardiomyopathy and complete atrioventricular block with prompt disappearance of outflow gradient after DDD pacing

• Published in: Europace (London, England) Vol. 1; no. 4; pp. 280 - 282
• Main Authors: Yesil, M, Bayata, S, Susam, I, Dinçkal, H, Postaci, N
• Format: Journal Article
• Language: English
• Published: England 01-10-1999
• Subjects: Adult; Cardiac Pacing, Artificial; Cardiomyopathy, Hypertrophic - complications; Electrocardiography; Female; Heart Block - diagnosis; Heart Block - etiology; Heart Block - physiopathology; Humans; Recurrence; Syncope - etiology; Ventricular Dysfunction, Left - etiology
• ISSN: 1099-5129
• DOI: 10.1053/eupc.1999.0051

Although arrhythmias are common in hypertrophic cardiomyopathy (HCM), complete atrioventricular (AV) block is very unusual. A 27-year-old female presented with a recent history of syncope and exercise intolerance. ECG demonstrated complete AV block. Two-dimensional Doppler echocardiography revealed HCM with a 60 mmHg left ventricular outflow tract (LVOT) gradient. A temporary transvenous ventricular pacemaker was inserted urgently, and subsequently replaced by a permanent DDD pacemaker. All symptoms were eliminated. This symptomatic improvement was associated with complete disappearance of LVOT gradient at the time of implantation. No gradient was observed during early follow-up and at 6 months after DDD pacemaker implantation.