Radiofrequency Catheter Ablation of the Accessory Pathway Adversely Affected the Left Ventricular Outflow Tract Pressure Gradient in a Patient With Hypertrophic Obstructive Cardiomyopathy

Atsuko Nakayama; Masao Takahashi; Kazuyoshi Hina; Katsuhito Fujiu; Hiroaki Sugiyama; Toshiya Kojima; Jiro Ando; Yasushi Imai; Yasunobu Hirata; Ryozo Nagai

doi:10.1536/ihj.54.111

Case Reports

Radiofrequency Catheter Ablation of the Accessory Pathway Adversely Affected the Left Ventricular Outflow Tract Pressure Gradient in a Patient With Hypertrophic Obstructive Cardiomyopathy

Atsuko Nakayama, Masao Takahashi, Kazuyoshi Hina, Katsuhito Fujiu, Hiroaki Sugiyama, Toshiya Kojima, Jiro Ando, Yasushi Imai, Yasunobu Hirata, Ryozo Nagai

Author information

Atsuko Nakayama
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Masao Takahashi
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Kazuyoshi Hina
Okayama Heart Clinic
Katsuhito Fujiu
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Hiroaki Sugiyama
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Toshiya Kojima
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Jiro Ando
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Yasushi Imai
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Yasunobu Hirata
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
Ryozo Nagai
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo

Keywords: Ablation, Dyssynchrony

JOURNAL FREE ACCESS

2013 Volume 54 Issue 2 Pages 111-114

DOI https://doi.org/10.1536/ihj.54.111

Details

Abstract

Although hypertrophic cardiomyopathy (HCM) with an accessory pathway is encountered in clinical practice, there is little evidence of a coherent strategy for ablation of the accessory pathway in patients with HCM. We present the case of a 61-year-old man who had type B Wolff-Parkinson-White (WPW) syndrome with hypertrophic obstructive cardiomyopathy (HOCM). Due to paroxysmal atrial fibrillation, he underwent radiofrequency catheter ablation of the accessory pathway located in the right postero-lateral wall to prevent secondary symptomatic events. His LV dyssynchrony improved after the procedure, but the degree of the LV outflow tract (LVOT) pressure gradient was increased. To stabilize the LVOT pressure gradient, he needed additional medications. This case shows that patients with HOCM should be carefully evaluated before making a decision concerning ablation of the accessory pathway.

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