ABSTRACT
Resumen La enfermedad de Chagas es endémica en América Latina y sigue siendo un problema regional a pesar de que su frecuencia ha disminuido gracias a importantes avances en salud ambiental. Para determinar su frecuencia en pacientes con enfermedades miocárdicas de El Salvador, se llevó a cabo una in vestigación observacional retrospectiva en nuestro hospital que es un centro de referencia de nivel nacional. Se revisó el registro del Laboratorio de Chagas en el período 2013-2015 para conocer cuántos individuos internados en la Unidad Cardiológica eran positivos por serología para infección chagásica y cuáles fueron sus diagnósticos. Se realizó un total de 1472 pruebas a pacientes individuales durante los 36 meses del período de estudio. De los 557 pacientes con serología positiva para Chagas, 97 (17.4%) fueron eventualmente hospitalizados en la Unidad Cardiológica. A su vez, estos 97 pacientes representaron el 33.7% de los 288 pacientes con cardiopatías. Entre los 97 con cardiopatía chagásica, 40 (41.2%) cumplieron criterios para colocación de marcapaso permanente, mientras que solo 13 de 191 (6.8%) enfermos con cardiopatías no chagásicas cumplieron esos criterios. La frecuencia de bloqueos auriculoventriculares asociados a infección por Trypanosoma cruzi resultó mucho mayor que las publicadas en estudios previos realizados en Sudamérica.
Abstract Chagas disease is endemic in Latin America and remains a regional problem despite improvements in en vironmental health conditions that have helped to control its transmission. To know more about its prevalence in heart disease patients, we carried out a survey in our national (El Salvador) reference hospital. We reviewed the Chagas Lab´s records 2013-2015 to find out how many of the patients admitted to the Hospital´s Heart Unit were serologically positives for Trypanosoma cruzi infection and which the associated diagnoses were. A total of 1472 patients were tested along the 36-month study period. Out of 557 (37.8%) patients with positive serology for Chagas infection, 97 (17.4%) were eventually admitted to the Heart Unit. Among these 97 Chagas infected patients with heart disease, 40 (41.2%) met the criteria for permanent pacemaker placement, while only 13 of 191 (6.8%) patients with non-chagasic heart disease met these criteria. The frequency of heart atrioventricular block associated with Trypanosoma cruzi infection was higher than frequencies reported in South American studies.
Subject(s)
Humans , Trypanosoma cruzi , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Atrioventricular Block/etiology , Atrioventricular Block/epidemiology , El Salvador , Latin AmericaABSTRACT
Objective To explore the role of remote monitoring in cardiology to promote its development in China.Methods The remote monitoring of implantable cardioverter defibrillator (ICD) and heart pacemaker was described from the aspects of system composition,measuring parameters,evaluation effect and clinical significance.Results The remote monitoring of ICD and heart pacemaker gained advantages over the traditional follow-up in timeliness,efficiency and etc.Conclusion Remote monitoring of ICD and heart pacemaker has great clinical significance in cardiology,and is worthy promoting practically.
ABSTRACT
Anesthesiologists are faced with a growing number of patients in need of cardiac pacing with symptoms of increasing complexity. Because intraoperative pacemaker malfunction can lead to sudden death, it is important for the anesthesiologists to possessthe information necessary to evaluate and treat such patients. On the other hand, torsade de pointes, a particular form of life-threatening polymorphic ventricular tachycardia, is known to be elicited in patients with cardiac pacemakers in the setting of abnormally long QT intervals, decreased heart rate and severe electrolyte disturbances, notably hypokalemia. We herein report a case of intraoperative torsade de pointes that was triggered by pacemaker malfunction-induced bradycardia in a patient with a VVI-type cardiac pacemaker, whose serum potassium and magnesium level were low preoperatively. (Korean J Anesthesiol 1999; 37: 164~167)