This method surgical correction obstructive SCOP is high and can become a method of choice in cases of obstruction simultaneous output divisions both testing, as well as in cases of obstruction srednejeludockova left chamber. In recent years, a growing interest is the possibility of using as an alternative to surgical treatment of patients obstructive SCOP consistent double elektrocardiostimulya tion atrioventrikuliarna short delay. Induced change in the consistency of wave excitation and reduce testing covers at the top, and then pour, leads to a reduction subaortalni gradient due to the reduction regionarna sokratimosti Paix and as a consequence expand pronouncing tract LV. This also contributes to the delay of systolic kperedi front door MCs and decrease its amplitude. It is important to the selection of the lower value of the time delay of ventricular momentum after predserdnyi, which provides early depoliarizatia top of the heart, without leading to a deterioration cardiogemodinamiki-lowering heart and the release of AD. This, in some cases, had to resort to a longer time spontaneous atrioventrikuliarna conductivity through therapy or β-blokatorami verapamilom and even ablation atrioventrikulyarnogo hub. While the initial uncontrolled observations were very encouraging, more recent randomized studies have shown that achieved with such elektrocardiostimulya No. symptomatic effect and the reduction subaortalni pressure gradient (about 25%) is relatively small, but significant changes in the physical efficiency lacking. Unable to locate and significant impact elektrocardiostimulya tions on the frequency of sudden death. The cause of the worsening diastolic myocardial relaxation and the konechno-diastolicesc th pressure in the LV. Obviously, pending clarification of the role of elektrocardiostimulya tions in the treatment of obstructive SCOP expanded clinical applications of this technique is not recommended. Another alternative to the treatment of obstructive refractor SCOP is transkateternaya septalnaya alcohol ablation. Etanolova ablation simulated gemodinamicakie changes after miectomii by reducing the thickness and mejjeludockova airway walls, improving flow from the left chamber, reducing the mitralna regurgitation. 1-3 ml (average 1.5-2 ml) pure ethanol give septalnuyu branch, causing heart from 3 to 10% of the left heart chamber (about 20% wall). The success of the ablation may rapid decline in the pressure gradient immediately after the operation. But there are progressive decline gradient within 6-12 months. The effect is achieved through remodelirovania walls. It is not a significant deterioration in the ability of contractile left chamber. The result is both in patients with a pressure gradient, and for those who obstruction displacement tract revealed only after provocative samples. Often after the operation there bifazny response : a sharp drop in the gradient through stanninga attack followed by the rise of 50% on the day, and then in the next few months, a gradual decline. Comparison of the results and miectomii septalna ablation showed identical levels lower gradient in the two operations. Other effects of ethanol ablation include : normalization of pressure in the left jeludocke, declining sistolicescoy overload.
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