Hypertrophic obstructive cardiomyopathy (HOCM) is a relatively common genetic disorder that exhibits wide variability in its clinical expression. Symptomatic patients most frequently experience exertional dyspnea, chest pain, fatigue and, occasionally, orthopnea or nocturnal dyspnea. Five to 10 % of symptomatic patients with HOCM are refractory to medical therapy (typically beta blockers and heart rate lowering calcium antagonists) and may require mechanical approaches targeting relief of obstruction and mitral regurgitation. Previously, mechanical approaches were limited to surgical myectomy, however, since the late 1990s increasing experience with a percutaneous technique, alcohol septal ablation, has become a widely-used alternative to surgical myectomy.
KeywordsPacemaker Heart failure Cardiac resynchronization
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