[SCD-FORUM] 15E RE: A female with burned-out phase of HCM? Dr. Kadish

[SCD Symposium]

She appears to have a familial cardiomypopathy. Some cohorts of
these patients have progressive heart block and LV dysfunciton. In
this case HCM may be associated. In other patients with progressive
heart block, an ASD may be present.

In  any case there is a risk of SCD with pacemaker therapy alone.
Certainly, in the presence of severe dysfunction and CHB, I would
suggest an ICD CRT device with the hope of improving function and
protecting aginst the risk of SCD.


Alan Kadish


>
> Dear Dr Dubner
>
>   thank you for this excellent  educational site
>
>   A 38 year old femal referred to our center with new onset dyspnea  
> from a few month ago. She had family history of sudden cardia  
> death. She had CHB with wide ventricular escape rhythm.  
> TT.echocardiography revealed sever LV and RV systolic dysfunction,  
> asymetric septal hyperthrophy, pulmonary hypertention  
> (PAP=65-70mmhg) and without LVOT gradient.patient,s dyspnea  
> improved with low dose diuretics , ACE inhibitor and TPM implantation.
>   Do you recommend DDD pacemaker for this patient?
>   or
>   Do you recommend  ICD-DR or ICD-CRT?
>
>   what is your opinion about clinical course of her disease?
>
>   does she need further workup before device implantation?
>
>   sincerely yours
>
>   Hormoz Alizadeh MD
>   Department of Pacemaker and Electrophysiology
> Rajaie Cardiovascular Medical and Research Center
> Tehran, Iran
>

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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