Guize L, Iliou M C, Lavergne T, Le Heuzey J Y
Service de Cardiologie A, Hôpital Broussais, Paris.
Ann Cardiol Angeiol (Paris). 1995 Jan;44(1):37-40.
The treatment of obstructive hypertrophic cardiomyopathy is classically based on beta blockers, cardiac calcium channel blockers or amiodarone to improve the symptoms and to decrease the intraventricular gradient. However, this treatment may prove to be insufficient or poorly tolerated. Two chamber cardiac pacing no constitutes an alternative to surgical treatment, as it improves the symptoms and decreases the left intraventricular gradient, by modifying the ventricular activation sequence. In order to be effective, ventricular pacing must be continuous, with a sufficiently short atrioventricular period to allow continuous ventricular preexcitation, while preserving atrial contraction. However, it has yet to be demonstrated that continuous ventricular pacing provides a survival benefit for these patients.
梗阻性肥厚型心肌病的治疗传统上基于β受体阻滞剂、心脏钙通道阻滞剂或胺碘酮,以改善症状并降低心室内梯度。然而,这种治疗可能被证明是不足的或耐受性差。双腔心脏起搏并不能替代手术治疗,因为它通过改变心室激动顺序来改善症状并降低左心室内梯度。为了有效,心室起搏必须是连续的,房室间期要足够短以允许持续的心室预激,同时保留心房收缩。然而,尚未证明持续心室起搏能为这些患者带来生存获益。