Cardiac resynchronization

The evolution of hypertrophic cardiomyopathy (HCM) towards dilatation and hypokinesis is an increas-ingly recognized complication with a high incidence of adverse outcomes, including sudden cardiac death, requiring defibrillator implantation and cardiac transplantation. It is generally regarded as the irreversible ‘burnt-out ’ end-stage manifestation of HCM. We report one of the first cases of profound regression of the dilated-hypokinetic state by the application of biventricular pacing and cardiac resynchronization therapy (CRT). Reviewing the literature on the role of pacing in HCM and the ener-getic rationale for CRT in HCM prompts us to suggest that further systematic studies are needed urgently to assess the role of CRT in HCM variants