Early results of AV sequential pacing on left ventricular outflow obstruction after Senning procedure

Dual chamber pacing was shown to decrease left ventricular outflow tract (L VOT) obstruction in patients with hypertrophic cardiomyopathy 30 years ago. We report early results of AV sequential pacing from the LV apex in a pati ent with transposition of the great arteries who is post-Senning procedure, LVOT obstruction resulted from septal deviation and systolic anterior moti on of the mitral valve, Pacing rr as indicated for sinus node dysfunction. AV sequential pacing with a short optimal AV interval of 60 ms demonstrated a 45% reduction in the degree of LVOT obstruction. This article suggests t hat LVOT obstruction after the Senning procedure can be palliated by asynch ronous septal contraction induced by AV sequential pacing, er en if the act ivation is from LV apex, and avoid or postpone surgery in selected situatio ns.