Vector electrocardiographic alterations after percutaneous septal ablation in obstructive hypertrophic cardiomyopathy. Possible anatomic causes.

Abstract

OBJECTIVE:

Analyze the dromotropic disturbances (vector-electrocardiographic), and the possible anatomic causes, provoked by selective alcohol injection in the septal branch, for percutaneous treatment, of obstructive hypertrophic cardiomyopathy.

METHODS:

Ten patients with a mean age of 52.7 years underwent percutaneous septal ablation (PTSA) from october 1998; all in functional class III/IV). Twelve-lead electrocardiogram was performed prior to and during PTSA, and later electrocardiogram and vectorcardiogram according to Frank's method. The patients were followed up for 32 months.

RESULTS:

On electrocardiogram (ECG) prior to PTSA all patients had sinus rhythm and left atrial enlargement, 8 left ventricular hypertrophy of systolic pattern. On ECG immediately after PTSA, 8 had complete right bundle-branch block; 1 transient total atrioventricular block; 1 alternating transient bundle-branch block either right or hemiblock. On late ECG 8 had complete right bundle-branch block confirmed by vectorcardiogram, type 1 or Grishman.

CONCLUSION:

Septal fibrosis following alcohol injection caused a predominance of complete right bundle-branch block, different from surgery of myotomy/myectomy.

• Authors: Andrés Ricardo Pérez Riera, Silvia Judith Fortunato de Cano, Manuel Nicolás Cano, Vera Márcia L Gimenez, Luciano Augusto de Padua Fleury Neto, José Eduardo M R Sousa
• Journal: Arquivos brasileiros de cardiologia (Arq Bras Cardiol) Vol. 79 Issue 5 Pg. 466-75 (Nov 2002) ISSN: 0066-782X [Print] Brazil
• PMID: 12447497 (Publication Type: Journal Article)

Chemical References

• Ethanol

Topics

• Adult
• Aged
• Bundle-Branch Block (chemically induced, physiopathology)
• Cardiomyopathy, Hypertrophic (physiopathology, surgery)
• Catheter Ablation (methods)
• Ethanol (therapeutic use)
• Female
• Fibrosis
• Heart Septum (drug effects, pathology, surgery)
• Humans
• Male
• Middle Aged
• Postoperative Period
• Vectorcardiography