Nonsurgical Septal Reduction Advantageous in Hypertrophic Cardiomyopathy

Nonsurgical septal reduction brings hemodynamic and morphological improvements superior to those of dual-chamber pacing in patients with hypertrophic obstructive cardiomyopathy, according to Polish researchers.

In fact, lead investigator Dr. Pawel Petkow Dimitrow told Reuters Health that he favors nonsurgical septal reduction as the first approach to appropriate patients with hypertrophic obstructive. This, he said, includes those with “significant symptoms despite pharmacotherapy, and massive hypertrophy of the septum.”

Both methods have been used to treat left ventricular outflow obstruction in patients with hypertrophic cardiomyopathy, the authors point out, but there has been no definitive evidence indicating that one method is superior to the other.

In the March issue of the International Journal of Cardiology, Dr. Dimitrow and colleagues from Collegium Medicum Jagiellonian University, Krakow, note that they compared the outcomes in 19 patients treated with dual-chamber pacing with those of 9 patients who underwent nonsurgical septal reduction.

Both treatments resulted in similar reductions in the left ventricular outflow tract gradient. . However, nonsurgical septal reduction induced regression of left ventricular hypertrophy and decreased the thickness of the septum. Such changes were not seen after dual-chamber pacing.

“Thus,” the investigators conclude, “not only hemodynamic but also morphological benefits from nonsurgical septal reduction seem to indicate the superiority of this method over dual-chamber pacing.”

Int J Cardiol 2004;94:31-34.