{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:17:18Z","timestamp":1769923038844,"version":"3.49.0"},"reference-count":29,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[1996,1]]},"abstract":"<jats:p>BACKGROUND--DDD pacing has been advocated as an effective treatment for drug refractory obstructive hypertrophic cardiomyopathy. This study reports the outcome of pacing in 56 patients with refractory symptoms referred to four tertiary centres. METHODS--Core data on symptoms, drug burden, and left ventricular outflow tract gradient were recorded. Patients underwent a temporary pacing study with optimisation of the atrioventricular (AV) delay for greatest gradient reduction without haemodynamic compromise. Patients were assessed after implantation in terms of changes in symptoms, drug load, and outflow tract gradient. RESULTS--56 patients underwent pacing assessment. The mean (SD) left ventricular outflow tract gradient before pacing was 78 (31) mm Hg. At temporary study the mean (SD) left ventricular outflow tract gradient was 38 (24) mm Hg with a median (range) optimised sensed AV delay of 65 (25-125) ms. Fifty three patients were implanted and followed up for a mean (SD) of 11 (11) months. The median (range) programmed sensed AV delay was 60 (31-200) ms. Left ventricular outflow tract gradient at follow up was 36 (25) mm Hg. Forty four patients had improved functional class. Although a correlation (r = 0.69) was shown between acute and chronic left ventricular outflow tract gradient reduction, there was no correlation between magnitude of gradient reduction and functional improvement, and no appreciable change in pharmacological burden. CONCLUSION--This series confirms symptomatic improvement after DDD pacing in hypertrophic cardiomyopathy. There remains, however, a discrepancy between perceived symptomatic benefit and modest objective improvement. Furthermore, the optimal outcome has been achieved only with continued pharmacological treatment. Current methods of temporary evaluation do not predict functional outcome which seems to be independent of the magnitude of gradient reduction.<\/jats:p>","DOI":"10.1136\/hrt.75.1.44","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:46:00Z","timestamp":1190137560000},"page":"44-49","source":"Crossref","is-referenced-by-count":100,"title":["DDD pacing in hypertrophic cardiomyopathy: a multicentre clinical experience."],"prefix":"10.1136","volume":"75","author":[{"given":"A. K.","family":"Slade","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Sadoul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Shapiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Chojnowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. P.","family":"Simon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. C.","family":"Saumarez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Dodinot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Camm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. J.","family":"McKenna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Aliot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/0002-9149(81)90535-X","article-title":"Prognosis in hypertrophic cardiomyopathy: role of age and clinical, electrocardiographic and hemodynamic features","volume":"47","author":"McKenna, W.; Deanfield, J.; Faruqui, A.; England, D.; Oakley, C.; Goodwin, J.","year":"1981","unstructured":"McKenna W, Deanfield J, Faruqui A, England D, Oakley C, Goodwin J. Prognosis in hypertrophic cardiomyopathy: role of age and clinical, electrocardiographic and hemodynamic features. 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Effects of verapamil on left ventricular systolic function and diastolic filling in patients with hypertrophic cardiomyopathy. Circulation 1981;64:787-96.","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1161\/01.CIR.78.3.487","article-title":"Current operative treatment of obstructive hypertrophic cardiomyopathy","volume":"78","author":"McIntosh, C.L.; Maron, B.J.","year":"1988","unstructured":"McIntosh CL, Maron BJ. Current operative treatment of obstructive hypertrophic cardiomyopathy. Circulation 1988;78:487-95.","journal-title":"Circulation"},{"key":"ref_5","first-page":"380","article-title":"Mitral valve replacement for idiopathic hypertrophic subaortic stenosis: results in 27 patients","volume":"17","author":"Cooley, D.A.; Wukasch, D.C.; Leachman, R.D.","year":"1976","unstructured":"Cooley DA, Wukasch DC, Leachman RD. Mitral valve replacement for idiopathic hypertrophic subaortic stenosis: results in 27 patients. J Cardiovasc Surg (Torino) 1976;17:380-7.","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/0140-6736(92)91961-7","article-title":"Effects of dualchamber pacing in hypertrophic obstructive cardiomyopathy","volume":"339","author":"Jeanrenaud, X.; Goy, J.J.; Kappenberger, L.","year":"1992","unstructured":"Jeanrenaud X, Goy JJ, Kappenberger L. Effects of dualchamber pacing in hypertrophic obstructive cardiomyopathy. Lancet 1992;339:1318-23.","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2149","DOI":"10.1161\/01.CIR.85.6.2149","article-title":"Impact of dual-chamber permanent pacing in patients with obstructive hypertrophic cardiomyopathy with symptoms refractory to verapamil and beta-adrenergic blocker therapy","volume":"85","author":"Fananapazir, L.; Cannon, R.O.; Tripodi, D.; Panza, J.A.","year":"1992","unstructured":"Fananapazir L, Cannon RO, Tripodi D, Panza JA. 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Hypertrophic cardiomyopathy: an important cause of sudden death. Arch Dis Child 1984;59:971-5.","journal-title":"Arch Dis Child"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2731","DOI":"10.1161\/01.CIR.90.6.2731","article-title":"Long term results of dual chamber pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy","volume":"90","author":"Fananapazir, L.; Epstein, N.D.; Curiel, R.V.; Panza, J.A.; Tripodi, D.; McAreavey, D.","year":"1994","unstructured":"Fananapazir L, Epstein ND, Curiel RV, Panza JA, Tripodi D, McAreavey D. Long term results of dual chamber pacing in obstructive hypertrophic cardiomyopathy. Evidence for progressive symptomatic and hemodynamic improvement and reduction of left ventricular hypertrophy. 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J Am Coll Cardiol 1989;14:499-507.","journal-title":"J Am Coll Cardiol"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/0002-9149(87)90306-7","article-title":"Importance of left atrial timing in the programming of dual-chamber pacemakers","volume":"60","author":"Wish, M.; Fletcher, R.D.; Gottdiener, J.S.; Cohen, A.I.","year":"1987","unstructured":"Wish M, Fletcher RD, Gottdiener JS, Cohen AI. Importance of left atrial timing in the programming of dual-chamber pacemakers. Am J Cardiol 1987;60: 566-71.","journal-title":"Am J Cardiol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0033-0620(85)90024-6","article-title":"Hypertrophic cardiomyopathy. The importance of the site and the extent of hypertrophy. A review","volume":"28","author":"Wigle, E.D.; Sasson, Z.; Henderson, M.A.","year":"1985","unstructured":"Wigle ED, Sasson Z, Henderson MA, et al. Hypertrophic cardiomyopathy. 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Dual chamber pacing for hypertrophic cardiomyopathy: has its time come? Br HeartJ 1994;70:301-3.","journal-title":"Br HeartJ"},{"key":"ref_25","article-title":"The effect of dual-chamber pacing on systolic and diastolic function in patients with hypertrophic cardiomyopathy: an acute Doppler\/catheterization hemodynamic study","author":"Symanski, J.D.; Nishimura, R.A.; Hayes, D.L.; Tajik, A.J.","year":"1994","unstructured":"Symanski JD, Nishimura RA, Hayes DL, Tajik AJ. The effect of dual-chamber pacing on systolic and diastolic function in patients with hypertrophic cardiomyopathy: an acute Doppler\/catheterization hemodynamic study [abstract]. Circulation 1994;90(4) Pt II:654.","journal-title":"Circulation"},{"key":"ref_26","article-title":"Atrio-ventricular pacing relieves obstruction but impairs diastolic function in hypertrophic cardiomyopathy","author":"Betocchi, S.; Losi, M.A.; Piscione, F.","year":"1994","unstructured":"Betocchi S, Losi MA, Piscione F, et al. Atrio-ventricular pacing relieves obstruction but impairs diastolic function in hypertrophic cardiomyopathy [abstract]. J Am Coll Cardiol 1994;23(suppl A):I 1.","journal-title":"J Am Coll Cardiol"},{"key":"ref_27","first-page":"401","article-title":"Dual chamber pacing improves left ventricular filling in patients with hypertrophic cardiomyopathy","volume":"1","author":"McDonald, K.; O'Sullivan, J.J.; King, G.; Conroy, R.; Maurer, B.","year":"1989","unstructured":"McDonald K, O'Sullivan JJ, King G, Conroy R, Maurer B. Dual chamber pacing improves left ventricular filling in patients with hypertrophic cardiomyopathy [abstract]. Eur HeartJ7 1989;1O(suppl):401."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0022-5223(19)33715-8","article-title":"Prognosis of patients with hypertrophic obstructive cardiomyopathy after transaortic myectomy. Late results up to twenty-five years","volume":"106","author":"Schulte, H.D.; Bircks, W.H.; Loesse, B.; Godehardt, E.A.; Schwartzkopff, B.","year":"1993","unstructured":"Schulte HD, Bircks WH, Loesse B, Godehardt EA, Schwartzkopff B. Prognosis of patients with hypertrophic obstructive cardiomyopathy after transaortic myectomy. Late results up to twenty-five years. J Thorac Cardiovasc Surg 1993;106:709-17.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref_29","first-page":"666","article-title":"The outcome of surgical treatment of hypertrophic obstructive cardiomyopathy. Experience over 15 years. J7 Thorac Cardiovasc Surg","volume":"97","author":"Mohr, R.; Schaff, H.V.; Danielson, G.K.; Hj, Puga; Pluth, JR, Tajik; A.J.","year":"1989","unstructured":"Mohr R, Schaff HV, Danielson GK, Puga Hj, Pluth JR, Tajik AJ. The outcome of surgical treatment of hypertrophic obstructive cardiomyopathy. Experience over 15 years. J7 Thorac Cardiovasc Surg 1989;97:666-74."}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.75.1.44","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T10:20:06Z","timestamp":1759832406000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.75.1.44"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1996,1,1]]},"published-print":{"date-parts":[[1996,1]]}},"alternative-id":["10.1136\/hrt.75.1.44"],"URL":"https:\/\/doi.org\/10.1136\/hrt.75.1.44","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,1]]}}}