[high gradients and DDD pacing]

Author: Paul Murphy (---.dsl.mindspring.com)

Date: 05-11-02 12:15

Caitlyn was diagnosed with HOCM last September right when she was turning 12. Her gradient was a bit over 100 at one of those early cardiologist appointments. She's been building up her doses of Verapamil (she's at 80 mg./day) and has shown improvement. She had another 24 hour Holter test a month ago that showed an occasional extra heartbeat, but the ped. cardiologist said that it's not significant, in and of itself. Then day before yesterday she had another stress test. Prior to the test she had an echo and her resting gradient was at 39 (yea!). She got through the stress test well, but the echo that followed showed that the gradient had zoomed up to a peak at 225. Her doctor was noticably concerned. There were no arhythmias during the stress test.

He is now suggesting Caitlyn have a heart cath to determine if she would do well with a DDD. He says in the cath lab they can mimic the reverse beating that the DDD would do and see if she would benefit by it. We mentioned to him that we've heard DDD pacing for HOCM children is still quite controversial and he said they've had good results with this procedure and reducing gradients in the patients they've treated. He's very open to us getting a second opinion, perhaps from Dr. Maron.

How wide should the range be between a gradient at rest and after excercise? We're still relatively new to all this, but that 225 gradient scared us silly.

Caitlyn complains of no symptoms, but it seems she does tire somewhat easily. She had two great grandfathers who died at younger ages from 'heart attacks', but no closer family connections that we can tie to HCM (and we're certainly not sure of those two).

Lisa, in a previous post you mentioned that there were studies by two multicenters that showed that results achieved by using DDDs for reducing gradients were statistically insignificant. Could you give me more details of these studies and where I might find them?

Paul

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[Re: high gradients and DDD pacing]

Author: s. beckley -moderator (---.dsl.mindspring.com)

Date: 05-11-02 18:35

Dear Paul,

It sounds like it is time to find an honest-to-god HCM specialist. Please call the office at 973-983-7429 to get some names and to get the info on those studies.

Sarah

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[Re: high gradients and DDD pacing]

Author: NURSE NANCY (207.109.18.---)

Date: 05-14-02 15:26

Please see Dr. Maron or Dr. Rick Nishimura at the Mayo clinic. Pacing in sch a young child is not highly recommended and may lead to heart failure. Get to either of these 2 MD's who are considered the worlds leading experts on HOCM. I am the mom od a HOCM child , I am a HOCM pt and I am an EP nurse .

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[Re: high gradients and DDD pacing]

Author: Sue (---.proxy.aol.com)

Date: 05-17-02 21:10

My son has a pacemaker defribulator..........is that the same as a DDD?????? What is a DDD????????????

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[Re: high gradients and DDD pacing]

Author: Paul Murphy (---.dsl.mindspring.com)

Date: 05-18-02 00:07

My understanding is that a DDD is a dual chamber pacemaker.

Paul