Abstract
Hypertrophic obstructive cardiomyopathy is characterized by left ventricular obstruction. The treatment of this condition has included the use of pharmacologic agents, atrioventricular sequential pacing, non-surgical alcoholic ablation of the hypertrophic septum and surgery. Techniques for operative management of hypertrophic cardiomyopathy are highly varied. Conduction problems after surgery most often include new left bundle branch block (3%-65%). From the literature, the incidence of immediate complete heart block after surgery is low (1%-i 0%). We report a patient with hypertrophic obstructive cardiomyopathy who received a modified Konno-Rastan procedure due to refractory symptoms under medical treatment. Bifascicular block occurred post-operatively. Unfortunately, paroxysmal complete heart block occurred 12 months later. Electrophysiologic study showed infra-Hisian block at a right atrium pacing cycle length of 470 msec under infusion of procanamide. Finally, a permanent VDD pacemker was implanted to maintain the resting rate.
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