Hypertrophic cardiomyopathy ventricular pacing: Difference between revisions

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(/* Pacing{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment o...)
(/* 2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE...)
 
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<ref name="Ommen, Nishimura et al 1999">Ommen SR, Nishimura RA, Squires RW, Schaff HV, Danielson GK, Tajik AJ. Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertropic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end points. ''[[Journal of the American College of Cardiology|J Am Coll Cardiol]]''. 1999 Jul; '''34'''(1):191–6. ([http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10400010 Medline abstract])</ref>. Dual chamber pacing does not decrease the risk of [[sudden cardiac death]] in these patients.
<ref name="Ommen, Nishimura et al 1999">Ommen SR, Nishimura RA, Squires RW, Schaff HV, Danielson GK, Tajik AJ. Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertropic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end points. ''[[Journal of the American College of Cardiology|J Am Coll Cardiol]]''. 1999 Jul; '''34'''(1):191–6. ([http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10400010 Medline abstract])</ref>. Dual chamber pacing does not decrease the risk of [[sudden cardiac death]] in these patients.


==2011 ACCF/AHA Guidelines for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy<ref name="pmid22075468">{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=25 |pages=2703–38 |year=2011 |month=December |pmid=22075468 |doi=10.1016/j.jacc.2011.10.825 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)04383-X |accessdate=2011-12-19}}</ref><ref name="pmid22075469">{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=25 |pages=e212–60 |year=2011 |month=December |pmid=22075469 |doi=10.1016/j.jacc.2011.06.011 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02275-3 |accessdate=2011-12-19}}</ref> and 2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities<ref name="pmid18534377">{{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.| title=ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary. | journal=Heart Rhythm | year= 2008 | volume= 5 | issue= 6 | pages= 934-55 | pmid=18534377 | doi=10.1016/j.hrthm.2008.04.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18534377  }} </ref> (DO NOT EDIT)==
==2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy<ref name="pmid22075469">{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=25 |pages=e212–60 |year=2011 |month=December |pmid=22075469 |doi=10.1016/j.jacc.2011.06.011 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02275-3 |accessdate=2011-12-19}}</ref> and 2012 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (DO NOT EDIT)<ref name="pmid23265327">{{cite journal |vauthors=Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO, Tracy CM, Epstein AE, Darbar D, DiMarco JP, Dunbar SB, Estes NA, Ferguson TB, Hammill SC, Karasik PE, Link MS, Marine JE, Schoenfeld MH, Shanker AJ, Silka MJ, Stevenson LW, Stevenson WG, Varosy PD |title=2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society |journal=J. Am. Coll. Cardiol. |volume=61 |issue=3 |pages=e6–75 |year=2013 |pmid=23265327 |doi=10.1016/j.jacc.2012.11.007 |url=}}</ref><ref name="pmid18534377">{{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.| title=ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary. | journal=Heart Rhythm | year= 2008 | volume= 5 | issue= 6 | pages= 934-55 | pmid=18534377 | doi=10.1016/j.hrthm.2008.04.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18534377  }} </ref> ==
===Pacing<ref name="pmid22075468">{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=25 |pages=2703–38 |year=2011 |month=December |pmid=22075468 |doi=10.1016/j.jacc.2011.10.825 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)04383-X |accessdate=2011-12-19}}</ref><ref name="pmid22075469">{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=25 |pages=e212–60 |year=2011 |month=December |pmid=22075469 |doi=10.1016/j.jacc.2011.06.011 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02275-3 |accessdate=2011-12-19}}</ref><ref name="pmid18534377">{{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.| title=ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary. | journal=Heart Rhythm | year= 2008 | volume= 5 | issue= 6 | pages= 934-55 | pmid=18534377 | doi=10.1016/j.hrthm.2008.04.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18534377  }} </ref>===
 
===Pacing (DO NOT EDIT)<ref name="pmid22075469">{{cite journal |author=Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW |title=2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=25 |pages=e212–60 |year=2011 |month=December |pmid=22075469 |doi=10.1016/j.jacc.2011.06.011 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02275-3 |accessdate=2011-12-19}}</ref><ref name="pmid18534377">{{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.| title=ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary. | journal=Heart Rhythm | year= 2008 | volume= 5 | issue= 6 | pages= 934-55 | pmid=18534377 | doi=10.1016/j.hrthm.2008.04.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18534377  }} </ref>===
{|class="wikitable"
{|class="wikitable"
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
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| bgcolor="LightGreen"|
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Permanent pacing is indicated for [[SND]] or [[AV block]] in patients with [[hypertrophic cardiomyopathy]] as described in [[Sick sinus syndrome surgery|permanent pacing in sinus node dysfunction]] and [[Atrioventricular block surgery|acquired atrioventricular block in adults]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
<nowiki>"</nowiki>'''1.''' Permanent pacing is indicated for [[SND]] or [[AV block]] in patients with [[hypertrophic cardiomyopathy]] as described in [[Sick sinus syndrome surgery|permanent pacing in sinus node dysfunction]] and [[Atrioventricular block surgery|acquired atrioventricular block in adults]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
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{|class="wikitable"
{|class="wikitable"
|-
|-
|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation for the purpose of reducing gradient should not be performed in patients with [[HCM]] who are asymptomatic or whose symptoms are medically controlled. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' In patients with [[HCM]] who have had a dual-chamber device implanted for non-HCM indications, it is reasonable to consider a trial of dual-chamber atrial-ventricular pacing (from the right ventricular apex) for the relief of symptoms attributable to [[LVOT obstruction]]<ref name="pmid10683657">{{cite journal |author=Erwin JP, Nishimura RA, Lloyd MA, Tajik AJ |title=Dual chamber pacing for patients with hypertrophic obstructive cardiomyopathy: a clinical perspective in 2000 |journal=Mayo Clin. Proc. |volume=75 |issue=2 |pages=173–80 |year=2000 |month=February |pmid=10683657 |doi=10.4065/75.2.173 |url=}}</ref><ref name="pmid10381856">{{cite journal |author=Gadler F, Linde C, Daubert C, ''et al.'' |title=Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy |journal=Eur. Heart J. |volume=20 |issue=14 |pages=1044–50 |year=1999 |month=July |pmid=10381856 |doi=10.1053/euhj.1998.1331 |url=}}</ref><ref name="pmid8624871">{{cite journal |author=Slade AK, Sadoul N, Shapiro L, ''et al.'' |title=DDD pacing in hypertrophic cardiomyopathy: a multicentre clinical experience |journal=Heart |volume=75 |issue=1 |pages=44–9 |year=1996 |month=January |pmid=8624871 |pmc=484221 |doi= |url=}}</ref><ref name="pmid10400010">{{cite journal |author=Ommen SR, Nishimura RA, Squires RW, Schaff HV, Danielson GK, Tajik AJ |title=Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertrophic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end points |journal=J. Am. Coll. Cardiol. |volume=34 |issue=1 |pages=191–6 |year=1999 |month=July |pmid=10400010 |doi= |url=}}</ref>. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Permanent pacemaker implantation should not be performed as a first-line therapy to relieve symptoms in medically refractory symptomatic patients with [[HCM]] and [[LVOT obstruction]] who are candidates for septal reduction. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Permanent pacing may be considered in medically refractory symptomatic patients with [[hypertrophic cardiomyopathy]] and significant resting or provoked [[LV outflow tract obstruction]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|-
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|bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' Permanent pacemaker implantation is not indicated for symptomatic patients without evidence of [[LV outflow tract obstruction]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
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{|class="wikitable"
{|class="wikitable"
|-
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent pacing may be considered in medically refractory symptomatic patients with obstructive [[HCM]] who are suboptimal candidates for [[Hypertrophic cardiomyopathy invasive therapy guidelines|septal reduction therapy]]<ref name="pmid10683657">{{cite journal |author=Erwin JP, Nishimura RA, Lloyd MA, Tajik AJ |title=Dual chamber pacing for patients with hypertrophic obstructive cardiomyopathy: a clinical perspective in 2000 |journal=Mayo Clin. Proc. |volume=75 |issue=2 |pages=173–80 |year=2000 |month=February |pmid=10683657 |doi=10.4065/75.2.173 |url=}}</ref><ref name="pmid10381856">{{cite journal |author=Gadler F, Linde C, Daubert C, ''et al.'' |title=Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy |journal=Eur. Heart J. |volume=20 |issue=14 |pages=1044–50 |year=1999 |month=July |pmid=10381856 |doi=10.1053/euhj.1998.1331 |url=}}</ref><ref name="pmid8624871">{{cite journal |author=Slade AK, Sadoul N, Shapiro L, ''et al.'' |title=DDD pacing in hypertrophic cardiomyopathy: a multicentre clinical experience |journal=Heart |volume=75 |issue=1 |pages=44–9 |year=1996 |month=January |pmid=8624871 |pmc=484221 |doi= |url=}}</ref><ref name="pmid10400010">{{cite journal |author=Ommen SR, Nishimura RA, Squires RW, Schaff HV, Danielson GK, Tajik AJ |title=Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertrophic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end points |journal=J. Am. Coll. Cardiol. |volume=34 |issue=1 |pages=191–6 |year=1999 |month=July |pmid=10400010 |doi= |url=}}</ref><ref name="pmid10359738">{{cite journal |author=Maron BJ, Nishimura RA, McKenna WJ, Rakowski H, Josephson ME, Kieval RS |title=Assessment of permanent dual-chamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY) |journal=Circulation |volume=99 |issue=22 |pages=2927–33 |year=1999 |month=June |pmid=10359738 |doi= |url=}}</ref>. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' In patients with [[HCM]] who have had a dual-chamber device implanted for non-HCM indications, it is reasonable to consider a trial of dual-chamber atrial-ventricular pacing (from the right ventricular apex) for the relief of symptoms attributable to [[LVOT obstruction]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
|}


{|class="wikitable"
{|class="wikitable"
|-
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit)
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Permanent pacemaker implantation is not indicated for patients who are asymptomatic or whose symptoms are medically controlled.<ref name="pmid10359738">{{cite journal |author=Maron BJ, Nishimura RA, McKenna WJ, Rakowski H, Josephson ME, Kieval RS |title=Assessment of permanent dual-chamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY) |journal=Circulation |volume=99 |issue=22 |pages=2927–33 |year=1999 |month=June |pmid=10359738 |doi= |url=}}</ref><ref name="pmid9015001">{{cite journal |author=Nishimura RA, Trusty JM, Hayes DL, ''et al.'' |title=Dual-chamber pacing for hypertrophic cardiomyopathy: a randomized, double-blind, crossover trial |journal=J. Am. Coll. Cardiol. |volume=29 |issue=2 |pages=435–41 |year=1997 |month=February |pmid=9015001 |doi= |url=}}</ref><ref name="pmid9458416">{{cite journal |author=Kappenberger L, Linde C, Daubert C, ''et al.'' |title=Pacing in hypertrophic obstructive cardiomyopathy. A randomized crossover study. PIC Study Group |journal=Eur. Heart J. |volume=18 |issue=8 |pages=1249–56 |year=1997 |month=August |pmid=9458416 |doi= |url=}}</ref>. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent pacing may be considered in medically refractory symptomatic patients with obstructive HCM who are suboptimal candidates for septal reduction therapy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Permanent pacemaker implantation should not be performed as a first-line therapy to relieve symptoms in medically refractory symptomatic patients with [[HCM]] and [[LVOT obstruction]] who are candidates for septal reduction<ref name="pmid10359738">{{cite journal |author=Maron BJ, Nishimura RA, McKenna WJ, Rakowski H, Josephson ME, Kieval RS |title=Assessment of permanent dual-chamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY) |journal=Circulation |volume=99 |issue=22 |pages=2927–33 |year=1999 |month=June |pmid=10359738 |doi= |url=}}</ref><ref name="pmid9015001">{{cite journal |author=Nishimura RA, Trusty JM, Hayes DL, ''et al.'' |title=Dual-chamber pacing for hypertrophic cardiomyopathy: a randomized, double-blind, crossover trial |journal=J. Am. Coll. Cardiol. |volume=29 |issue=2 |pages=435–41 |year=1997 |month=February |pmid=9015001 |doi= |url=}}</ref><ref name="pmid9458416">{{cite journal |author=Kappenberger L, Linde C, Daubert C, ''et al.'' |title=Pacing in hypertrophic obstructive cardiomyopathy. A randomized crossover study. PIC Study Group |journal=Eur. Heart J. |volume=18 |issue=8 |pages=1249–56 |year=1997 |month=August |pmid=9458416 |doi= |url=}}</ref>. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Permanent pacing may be considered in medically refractory symptomatic patients with hypertrophic cardiomyopathy and significant resting or provoked [[LV outflow tract obstruction]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' Permanent pacemaker implantation is not indicated for symptomatic patients without evidence of [[LV outflow tract obstruction]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
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==2007 ESC Guidelines- Cardiac Pacing in HCM <ref name="pmid17726043">{{cite journal| author=Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H et al.| title=Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. | journal=Europace | year= 2007 | volume= 9 | issue= 10 | pages= 959-98 | pmid=17726043 | doi=10.1093/europace/eum189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17726043  }} </ref>==
==2007 ESC Guidelines for Cardiac Pacing and Cardiac Resynchronization Therapy (DO NOT EDIT)<ref name="pmid17726043">{{cite journal| author=Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H et al.| title=Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. | journal=Europace | year= 2007 | volume= 9 | issue= 10 | pages= 959-98 | pmid=17726043 | doi=10.1093/europace/eum189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17726043  }} </ref>==
 
===Cardiac Pacing in HCM<ref name="pmid17726043">{{cite journal| author=Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H et al.| title=Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. | journal=Europace | year= 2007 | volume= 9 | issue= 10 | pages= 959-98 | pmid=17726043 | doi=10.1093/europace/eum189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17726043  }} </ref>===
{|class="wikitable"
{|class="wikitable"
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|colspan="1" style="text-align:center; background:LightCoral"|[[European society of cardiology#Classes of Recommendations|Class III]]
|colspan="1" style="text-align:center; background:LightCoral"|[[European society of cardiology#Classes of Recommendations|Class III]]
|-
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|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Asymptomatic patients. ''([[European society of cardiology#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Asymptomatic patients. ''([[European society of cardiology#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
 
|-
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|bgcolor="LightCoral"|<nowiki>"</nowiki> '''2.''' Symptomatic patients who do not have [[LVOT]] obstruction. ''([[European society of cardiology#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Symptomatic patients who do not have [[LVOT obstruction]]. ''([[European society of cardiology#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
 
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[European society of cardiology#Classes of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[European society of cardiology#Classes of Recommendations|Class IIa]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Symptomatic [[bradycardia]] due to [[Beta blockers|beta-blockade]] when alternative therapies are unacceptable. ''([[European society of cardiology#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Symptomatic [[bradycardia]] due to [[Beta blockers|beta-blockade]] when alternative therapies are unacceptable. ''([[European society of cardiology#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
|}


Line 70: Line 69:
| colspan="1" style="text-align:center; background:LemonChiffon"|[[European society of cardiology#Classes of Recommendations|Class IIb]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[European society of cardiology#Classes of Recommendations|Class IIb]]
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Patients with drug refractory hypertrophic cardiomyopathy with significant resting or provoked [[LVOT]] gradient <ref name="pmid1350522">{{cite journal| author=Fananapazir L, Cannon RO, Tripodi D, Panza JA| title=Impact of dual-chamber permanent pacing in patients with obstructive hypertrophic cardiomyopathy with symptoms refractory to verapamil and beta-adrenergic blocker therapy. | journal=Circulation | year= 1992 | volume= 85 | issue= 6 | pages= 2149-61 | pmid=1350522 | doi= | pmc= | url= }} </ref><ref name="pmid7994815">{{cite journal| author=Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D, McAreavey D| title=Long-term results of dual-chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy. | journal=Circulation | year= 1994 | volume= 90 | issue= 6 | pages= 2731-42 | pmid=7994815 | doi= | pmc= | url= }} </ref><ref name="pmid9458416">{{cite journal| author=Kappenberger L, Linde C, Daubert C, McKenna W, Meisel E, Sadoul N et al.| title=Pacing in hypertrophic obstructive cardiomyopathy. A randomized crossover study. PIC Study Group. | journal=Eur Heart J | year= 1997 | volume= 18 | issue= 8 | pages= 1249-56 | pmid=9458416 | doi= | pmc= | url= }} </ref> and contraindications for [[Hypertrophic cardiomyopathy interventional cardiology#Alcohol septal ablation|septal ablation]] or [[septal mectomy|myectomy]]. ''([[European society of cardiology#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Patients with drug refractory hypertrophic cardiomyopathy with significant resting or provoked [[LVOT]] gradient <ref name="pmid1350522">{{cite journal| author=Fananapazir L, Cannon RO, Tripodi D, Panza JA| title=Impact of dual-chamber permanent pacing in patients with obstructive hypertrophic cardiomyopathy with symptoms refractory to verapamil and beta-adrenergic blocker therapy. | journal=Circulation | year= 1992 | volume= 85 | issue= 6 | pages= 2149-61 | pmid=1350522 | doi= | pmc= | url= }} </ref><ref name="pmid7994815">{{cite journal| author=Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D, McAreavey D| title=Long-term results of dual-chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy. | journal=Circulation | year= 1994 | volume= 90 | issue= 6 | pages= 2731-42 | pmid=7994815 | doi= | pmc= | url= }} </ref><ref name="pmid9458416">{{cite journal| author=Kappenberger L, Linde C, Daubert C, McKenna W, Meisel E, Sadoul N et al.| title=Pacing in hypertrophic obstructive cardiomyopathy. A randomized crossover study. PIC Study Group. | journal=Eur Heart J | year= 1997 | volume= 18 | issue= 8 | pages= 1249-56 | pmid=9458416 | doi= | pmc= | url= }} </ref> and contraindications for [[Hypertrophic cardiomyopathy interventional cardiology#Alcohol septal ablation|septal ablation]] or [[septal mectomy|myectomy]]. ''([[European society of cardiology#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|}
|}


==Guideline Resources==
==Sources==
*[http://circ.ahajournals.org/content/117/21/e350.full.pdf ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities] <ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>
*[http://circ.ahajournals.org/content/117/21/e350.full.pdf ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities] <ref name="pmid18534377">{{cite journal| author=Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS et al.| title=ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary. | journal=Heart Rhythm | year= 2008 | volume= 5 | issue= 6 | pages= 934-55 | pmid=18534377 | doi=10.1016/j.hrthm.2008.04.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18534377  }} </ref>


*[http://europace.oxfordjournals.org/content/9/10/959.full.pdf The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association] <ref name="pmid17726043">{{cite journal| author=Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H et al.| title=Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. | journal=Europace | year= 2007 | volume= 9 | issue= 10 | pages= 959-98 | pmid=17726043 | doi=10.1093/europace/eum189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17726043  }} </ref>
*[http://europace.oxfordjournals.org/content/9/10/959.full.pdf The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association] <ref name="pmid17726043">{{cite journal| author=Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H et al.| title=Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association. | journal=Europace | year= 2007 | volume= 9 | issue= 10 | pages= 959-98 | pmid=17726043 | doi=10.1093/europace/eum189 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17726043  }} </ref>

Latest revision as of 14:46, 31 October 2016

Hypertrophic Cardiomyopathy Microchapters

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Hypertrophic cardiomyopathy ventricular pacing On the Web

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D. [2]; Caitlin J. Harrigan [3]; Martin S. Maron, M.D.; Barry J. Maron, M.D.; Lakshmi Gopalakrishnan, M.B.B.S. [4]

Overview

The use of a pacemaker has been advocated in a subset of individuals, in order to cause asynchronous contraction of the left ventricle. Since the pacemaker activates the interventricular septum before the left ventricular free wall, the gradient across the left ventricular outflow tract may decrease. The AV interval must be shortened to do this, but not at the expense of diastolic filling. This form of treatment has been shown to provide less relief of symptoms and less of a reduction in the left ventricular outflow tract gradient when compared to surgical myectomy [1]. Dual chamber pacing does not decrease the risk of sudden cardiac death in these patients.

2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy[2] and 2012 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (DO NOT EDIT)[3][4]

Pacing (DO NOT EDIT)[2][4]

Class I
"1. Permanent pacing is indicated for SND or AV block in patients with hypertrophic cardiomyopathy as described in permanent pacing in sinus node dysfunction and acquired atrioventricular block in adults. (Level of Evidence: C)"
Class IIa
"1. In patients with HCM who have had a dual-chamber device implanted for non-HCM indications, it is reasonable to consider a trial of dual-chamber atrial-ventricular pacing (from the right ventricular apex) for the relief of symptoms attributable to LVOT obstruction[5][6][7][8]. (Level of Evidence: B)"
"2. Permanent pacing may be considered in medically refractory symptomatic patients with hypertrophic cardiomyopathy and significant resting or provoked LV outflow tract obstruction. (Level of Evidence: A)"
Class IIb
"1. Permanent pacing may be considered in medically refractory symptomatic patients with obstructive HCM who are suboptimal candidates for septal reduction therapy[5][6][7][8][9]. (Level of Evidence: B)"
Class III (No Benefit)
"1. Permanent pacemaker implantation is not indicated for patients who are asymptomatic or whose symptoms are medically controlled.[9][10][11]. (Level of Evidence: C)"
"2. Permanent pacemaker implantation should not be performed as a first-line therapy to relieve symptoms in medically refractory symptomatic patients with HCM and LVOT obstruction who are candidates for septal reduction[9][10][11]. (Level of Evidence: B)"
"3. Permanent pacemaker implantation is not indicated for symptomatic patients without evidence of LV outflow tract obstruction. (Level of Evidence: C)"

2007 ESC Guidelines for Cardiac Pacing and Cardiac Resynchronization Therapy (DO NOT EDIT)[12]

Cardiac Pacing in HCM[12]

Class III
"1. Asymptomatic patients. (Level of Evidence: C)"
"2. Symptomatic patients who do not have LVOT obstruction. (Level of Evidence: C)"
Class IIa
"1. Symptomatic bradycardia due to beta-blockade when alternative therapies are unacceptable. (Level of Evidence: C)"
Class IIb
"1. Patients with drug refractory hypertrophic cardiomyopathy with significant resting or provoked LVOT gradient [13][14][11] and contraindications for septal ablation or myectomy. (Level of Evidence: A)"

Sources

References

  1. ↑ Ommen SR, Nishimura RA, Squires RW, Schaff HV, Danielson GK, Tajik AJ. Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertropic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end points. J Am Coll Cardiol. 1999 Jul; 34(1):191–6. (Medline abstract)
  2. ↑ 2.0 2.1 2.2 Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011). "2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Journal of the American College of Cardiology. 58 (25): e212–60. doi:10.1016/j.jacc.2011.06.011. PMID 22075469. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)
  3. ↑ Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO, Tracy CM, Epstein AE, Darbar D, DiMarco JP, Dunbar SB, Estes NA, Ferguson TB, Hammill SC, Karasik PE, Link MS, Marine JE, Schoenfeld MH, Shanker AJ, Silka MJ, Stevenson LW, Stevenson WG, Varosy PD (2013). "2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society". J. Am. Coll. Cardiol. 61 (3): e6–75. doi:10.1016/j.jacc.2012.11.007. PMID 23265327.
  4. ↑ 4.0 4.1 4.2 Epstein AE, Dimarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS; et al. (2008). "ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary". Heart Rhythm. 5 (6): 934–55. doi:10.1016/j.hrthm.2008.04.015. PMID 18534377.
  5. ↑ 5.0 5.1 Erwin JP, Nishimura RA, Lloyd MA, Tajik AJ (2000). "Dual chamber pacing for patients with hypertrophic obstructive cardiomyopathy: a clinical perspective in 2000". Mayo Clin. Proc. 75 (2): 173–80. doi:10.4065/75.2.173. PMID 10683657. Unknown parameter |month= ignored (help)
  6. ↑ 6.0 6.1 Gadler F, Linde C, Daubert C; et al. (1999). "Significant improvement of quality of life following atrioventricular synchronous pacing in patients with hypertrophic obstructive cardiomyopathy. Data from 1 year of follow-up. PIC study group. Pacing In Cardiomyopathy". Eur. Heart J. 20 (14): 1044–50. doi:10.1053/euhj.1998.1331. PMID 10381856. Unknown parameter |month= ignored (help)
  7. ↑ 7.0 7.1 Slade AK, Sadoul N, Shapiro L; et al. (1996). "DDD pacing in hypertrophic cardiomyopathy: a multicentre clinical experience". Heart. 75 (1): 44–9. PMC 484221. PMID 8624871. Unknown parameter |month= ignored (help)
  8. ↑ 8.0 8.1 Ommen SR, Nishimura RA, Squires RW, Schaff HV, Danielson GK, Tajik AJ (1999). "Comparison of dual-chamber pacing versus septal myectomy for the treatment of patients with hypertrophic obstructive cardiomyopathy: a comparison of objective hemodynamic and exercise end points". J. Am. Coll. Cardiol. 34 (1): 191–6. PMID 10400010. Unknown parameter |month= ignored (help)
  9. ↑ 9.0 9.1 9.2 Maron BJ, Nishimura RA, McKenna WJ, Rakowski H, Josephson ME, Kieval RS (1999). "Assessment of permanent dual-chamber pacing as a treatment for drug-refractory symptomatic patients with obstructive hypertrophic cardiomyopathy. A randomized, double-blind, crossover study (M-PATHY)". Circulation. 99 (22): 2927–33. PMID 10359738. Unknown parameter |month= ignored (help)
  10. ↑ 10.0 10.1 Nishimura RA, Trusty JM, Hayes DL; et al. (1997). "Dual-chamber pacing for hypertrophic cardiomyopathy: a randomized, double-blind, crossover trial". J. Am. Coll. Cardiol. 29 (2): 435–41. PMID 9015001. Unknown parameter |month= ignored (help)
  11. ↑ 11.0 11.1 11.2 Kappenberger L, Linde C, Daubert C; et al. (1997). "Pacing in hypertrophic obstructive cardiomyopathy. A randomized crossover study. PIC Study Group". Eur. Heart J. 18 (8): 1249–56. PMID 9458416. Unknown parameter |month= ignored (help)
  12. ↑ 12.0 12.1 12.2 Vardas PE, Auricchio A, Blanc JJ, Daubert JC, Drexler H, Ector H; et al. (2007). "Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association". Europace. 9 (10): 959–98. doi:10.1093/europace/eum189. PMID 17726043.
  13. ↑ Fananapazir L, Cannon RO, Tripodi D, Panza JA (1992). "Impact of dual-chamber permanent pacing in patients with obstructive hypertrophic cardiomyopathy with symptoms refractory to verapamil and beta-adrenergic blocker therapy". Circulation. 85 (6): 2149–61. PMID 1350522.
  14. ↑ Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D, McAreavey D (1994). "Long-term results of dual-chamber (DDD) pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy". Circulation. 90 (6): 2731–42. PMID 7994815.
  15. ↑ Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011). "2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Journal of the American College of Cardiology. 58 (25): 2703–38. doi:10.1016/j.jacc.2011.10.825. PMID 22075468. Retrieved 2011-12-19. Unknown parameter |month= ignored (help)


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