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2.
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.342-347, tab.
Monography in Portuguese | LILACS | ID: biblio-1352400
4.
Arq. bras. cardiol ; 116(5): 908-916, nov. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1248912

ABSTRACT

Resumo Fundamento: Nas últimas décadas, o número de dispositivos eletrônicos cardíacos implantáveis (DCEI) aumentou consideravelmente, assim como a necessidade de remoção destes. Neste contexto, a remoção percutânea apresenta-se como uma técnica segura e capaz de evitar uma cirurgia cardíaca convencional. Objetivos: Primário: descrever a taxa de sucesso e complicações da remoção percutânea de DCEI em um hospital público brasileiro. Secundário: estabelecer preditores de sucesso e complicações. Métodos: Serie de casos retrospectiva de todos os pacientes submetidos à remoção de DCEI em um hospital público brasileiro no período de janeiro de 2013 a junho de 2018. Remoção, explante e extração de eletrodos, complicações e desfechos foram definidos conforme a diretriz norte-americana de 2017. Variáveis categóricas foram comparadas pelos testes Qui-quadrado ou Fisher, enquanto variáveis contínuas, por testes não pareados. O nível de significância adotado nas análises estatísticas foi de 5%. Resultados: 61 pacientes foram submetidos à remoção de DCEI, sendo 51 extrações e 10 explantes. No total, 128 eletrodos foram removidos. Taxa de sucesso clínico foi 100% no grupo do explante e 90,2% no da extração (p=0,58). Complicações maiores foram encontradas em 6,6% dos pacientes. Falha do procedimento foi associada a eletrodos de ventrículo (p=0,05) e átrio (p=0,04) direito implantados há mais tempo. Duração do procedimento (p=0,003) e necessidade de transfusão sanguínea (p<0,001) foram associadas a maior índice de complicação. Conclusão: As taxas de complicação e sucesso clínico observadas foram de 11,5% e 91,8%, respectivamente. Remoções de eletrodos atriais e ventriculares mais antigos estiveram associados a menores taxa de sucesso. Procedimentos mais longos e necessidade de transfusão sanguínea foram associados a complicações.


Abstract Background: In the last decade, the number of cardiac electronic devices has risen considerably and consequently the occasional need for their removal. Concurrently, the transvenous lead removal became a safe procedure that could prevent open-heart surgery. Objective: The primary objective of this study was to describe the successful performance and the complication rates of pacemaker removals in a Brazilian public hospital. Our secondary aim was to describe the variables associated to successes and complications. Methods: A retrospective case series was conducted in patients submitted to pacemaker removal in a Brazilian public hospital from January 2013 to June 2018. Removal, explant, extraction, success and complication rates were defined by the 2017 Heart Rhythm Society Guideline. Categorical variables were compared using x2 or Fisher's tests, while continuous variables were compared by unpaired tests. A p-value of 0.05 was considered statistically significant. Results: Cardiac device removals were performed in 61 patients, of which 51 were submitted to lead extractions and 10 to lead explants. In total, 128 leads were removed. Our clinical success rate was 100% in the explant group and 90.2% in the extraction one (p=0.58). Major complications were observed in 6.6% patients. Procedure failure was associated to older right ventricle (p=0.05) and atrial leads (p=0,04). Procedure duration (p=0.003) and need for blood transfusion (p<0,001) were associated to more complications. Conclusion: Complications and clinical success were observed in 11.5% and 91.8% of the population, respectively. Removal of older atrial and ventricular leads were associated with lower success rates. Longer procedures and blood transfusions were associated with complications.


Subject(s)
Humans , Pacemaker, Artificial/adverse effects , Defibrillators, Implantable , Brazil , Retrospective Studies , Treatment Outcome , Device Removal
7.
Arch. cardiol. Méx ; 91(2): 186-189, abr.-jun. 2021. graf
Article in English | LILACS | ID: biblio-1248783

ABSTRACT

Abstract Objective: The objective of this study was to describe the case of a 19-year-old male presenting with bradycardia and hypotension after a honeybee sting making a review of the literature and pathophysiology of the cardiovascular and electrocardiogram (EKG) changes after a bee sting. Methods: The patient's airway was inspected and secured. Electrocardiogram with an idioventricular rhythm at 41' bpm. Oxygen was administered, an intravenous access was established, and the transcutaneous pacemaker leads were placed on the chest of the patient, then published guidelines management was induced. Results: The EKG showed idioventricular rhythm at a rate of 41 beats/min that resolved to a normal sinus rhythm after treatment. Conclusions: A full and prompt cardiovascular evaluation should be performed in all patients presenting to the emergency department after a bee sting, and published guidelines regarding the management of bradycardia and anaphylaxis should be followed to achieve successful outcomes.


Resumen Objetivo: Describir el caso de un paciente masculino de 19 años que presenta bradicardia e hipotensión después de una picadura de abeja haciendo una revisión de la literatura y fisiopatología de los cambios cardiovasculares y electrocardiográficos después de una picadura de abeja. Métodos: Se inspeccionó y aseguró la vía aérea del paciente. Un rastreo de ECG realizado al ingreso reveló ritmo idioventricular a una ritmo de 41 latidos por minuto. Se administró oxígeno, se estableció un acceso IV y se colocaron los cables del marcapasos transcutáneo en el tórax del paciente, luego se indujo el manejo de las guías publicadas. Resultados: El electrocardiograma mostró un ritmo idioventricular a una frecuencia de 41 latidos por minuto que se resolvió a un ritmo sinusal normal después del tratamiento. Conclusiones: Se debe realizar una evaluación cardiovascular completa y rápida en todos los pacientes que se presentan al departamento de emergencias después de una picadura de abeja, y se deben seguir las pautas publicadas sobre el manejo de la bradicardia y la anafilaxia para lograr resultados exitosos.


Subject(s)
Humans , Animals , Male , Pacemaker, Artificial , Arrhythmias, Cardiac/diagnosis , Shock , Bees , Bradycardia/etiology , Insect Bites and Stings/complications , Arrhythmias, Cardiac/etiology , Bradycardia/therapy , Electrocardiography , Heart Rate/physiology
8.
Rev. argent. cir. plást ; 27(2): 60-66, 20210000. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1357632

ABSTRACT

La ubicación habitual de los marcapasos y cardiodesfibriladores implantables (CDI) es en el plano subcutáneo subclavicular. Este bolsillo, de fácil realización, no está exento de complicaciones propias (necrosis de piel, seromas, síndrome de Twiddler) así como también provocar un defecto estético al visualizarse el aparato bajo la piel. Estas complicaciones son mayores en pacientes delgadas y con actividad deportiva debido a la exposición traumática. Con el objeto de evitar los factores mencionados anteriormente, así como para mejorar el aspecto cosmético, mostramos nuestra experiencia en la ubicación en un plano más profundo, submuscular (entre m. pectoralis major y m. pectoralis minor, T.A.). Creemos que esta ubicación es de elección en pacientes muy delgadas, deportistas, con riesgo de traumatismo en la zona y en todos aquellos donde ha fallado la ubicación subcutánea.


The pacemakers and implantable cardioverter defibrillators (ICD) location is in the subcutaneous plane, subclavicular zone. This pocket, easy to perform, is not free of complications (skin necrosis, seroma, Twiddler syndrome) as well as an aesthetic defect due to the device being observed under the skin. These complications are higher in thin and sportive patients. In order to avoid the above factors as well as to improve the cosmetic appearance, our experience shows better results on a deeper level, submuscular (between m. pectoralis major and m. pectoralis minor, T.A.). We believe that this location is preferable in very thin patients and athletes because it avoids the risk of trauma to the area. Also,we advise this plane in particular cases which failed subcutaneous locations


Subject(s)
Humans , Pacemaker, Artificial , Pectoralis Muscles/surgery , Dissection
9.
Arq. bras. cardiol ; 116(6): 1080-1088, Jun. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1278337

ABSTRACT

Resumo Fundamento Houve aumento expressivo na incidência de infecções relacionadas a dispositivos cardíacos eletrônicos implantáveis (DCEI) nos últimos anos, com impacto na mortalidade. Objetivos Verificar a proporção de pacientes com infecção de DCEI e analisar seu perfil clínico, as variáveis relacionadas com a infecção e sua evolução. Método Estudo retrospectivo, observacional e longitudinal com 123 pacientes com infecção de DCEI entre 6.406 procedimentos. Foram usados os testes paramétricos, e o nível de significância adotado na análise estatística foi de 5%. Resultados A idade média dos pacientes foi de 60,1 anos, e 71 eram homens. A média de internação foi de 35,3 dias, e houve remoção total do sistema em 105 pacientes. Identificaram-se endocardite infecciosa (EI) e sepse em 71 e 23 pacientes, respectivamente. A mortalidade intra-hospitalar foi 19,5%. Houve associação entre EI e extrusão do gerador (17,0% vs. 19,5% nos grupos com e sem EI, respectivamente, p = 0,04; associação inversa) e sepse (15,4% vs. 3,2%, p = 0,01). Houve associação entre morte intra-hospitalar e EI (83,3% vs. 52,0% com e sem morte, respectivamente, p = 0,005) e sepse (62,5% vs. 8,1%, p < 0,0001). Foi dada alta hospitalar a 99 pacientes. Durante a média de seguimento clínico de 43,8 meses, a taxa de mortalidade foi de 43%, e 65,2% dos pacientes com sepse faleceram (p < 0,0001). A curva de sobrevida de Kaplan-Meier não indicou associação significante com sexo, agente etiológico, fração de ejeção, EI e modalidade de tratamento. A taxa de mortalidade foi de 32,8% entre os pacientes submetidos a reimplante de eletrodos por via endocárdica e 52,2% entre aqueles por via epicárdica (p = 0,04). Não houve influência da etiologia chagásica, a qual correspondeu a 44,7% das cardiopatias de base, quanto às variáveis clínicas e laboratoriais ou à evolução. Conclusões A taxa de infecção foi de 1,9%, com predomínio em homens. Houve associação entre mortalidade intra-hospitalar e EI e sepse. Após a alta hospitalar, a taxa de mortalidade anual foi de 11,8%, com influência de sepse durante a internação e o implante epicárdico. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)


Abstract Background In recent years, the incidence of infections related to cardiac implantable electronic devices (CIED) has increased sharply, impacting mortality. Objective To verify the proportion of patients with CIED infection; to analyze their clinical profile and the variables related to the infection and its progression. Methods Retrospective and longitudinal observational study including 123 patients with CIED infection among 6406 procedures. Parametric tests and a level of significance of 5% were used in the statistical analyses Results The mean age of patients was 60.1 years and mean length of stay in hospital was 35.3 days; most (71) patients were male, and the system was completely removed in 105 cases. Infectious endocarditis (IE) and sepsis were observed in 71 and 23 patients, respectively. Intra-hospital mortality was 19.5%. IE was associated with extrusion of the generator (17.0% vs 19.5% with and without IE, respectively, p = 0.04, inverse association) and sepsis (15.4% vs 3.2%, p = 0.01). Intra-hospital death was associated with IE (83.3% vs 52.0% with and without intra-hospital death, respectively, p = 0.005) and sepsis (62.5% vs 8.1%, p < 0.0001). Ninety-nine patients were discharged. During a mean follow-up of 43.8 months, mortality rate was 43%; among patients with sepsis, it was 65.2% (p < 0.0001). By applying a Kaplan-Meier survival curve, we did not indicate significant associations with sex, etiologic agent, ejection fraction, IE, or treatment modality. The death rate was 32.8% for patients subjected to endocardial electrode reimplantation and 52.2% for epicardial reimplantation (p = 0.04). Chagasic etiology (44.7% of the baseline heart diseases) did not influence clinical and laboratory variables or disease progression. Conclusion The infection rate was 1.9%, mostly in men. We observed an association of intra-hospital mortality with IE and sepsis. After discharge, the annual mortality rate was 11.8%, influenced by sepsis during hospitalization and epicardial implantation. (Arq Bras Cardiol. 2021; [online].ahead print, PP.0-0)


Subject(s)
Humans , Male , Female , Pacemaker, Artificial , Surgical Procedures, Operative , Endocarditis , Infections , Clinical Evolution , Hospital Mortality , Sepsis
12.
Acta méd. colomb ; 46(1): 20-26, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1278151

ABSTRACT

Resumen Introducción: en una unidad de electrofisiología de un hospital de tercer nivel de Manizales, Caldas, se han atendido pacientes en la cuarta edad; sin embargo, existe poca claridad en la literatura sobre las conductas terapéuticas en este grupo etario. Presentamos nuestra experiencia de atención e intervención en pacientes mayores de 80 años entre el 20 de septiembre de 2017 y 7 de octubre de 2019. Métodos: estudio tipo cohorte longitudinal, se recogió información con base en revisión de historias clínicas. Se realizaron seguimientos telefónicos al tercer y sexto mes del procedimiento. Se incluyeron pacientes mayores de 80 años intervenidos de cualquier procedimiento en la sala de electrofisiología. Se excluyeron los pacientes sin información sobre los datos de seguimiento. Resultados: se recogieron datos de 75 pacientes llevados a procedimiento. El 62.7% de los pacientes fueron hombres, las edades oscilaron entre 80 y 95 años. 32.7%, de pacientes con diagnóstico de disfunción sinusal. La comorbilidad más prevalente fue hipertensión arterial (92%). El procedimiento más realizado fue el implante de marcapaso bicameral. La mediana del tiempo de estancia hospitalaria fue de 1 día. EL 70% de los pacientes tuvieron riesgo medio o bajo según la escala CHA2DS2VASc. En el lapso de seis meses se encontró una incidencia acumulada de complicaciones de 4%, con 8% de reconsultas y una mortalidad de 1.3%. Conclusiones: las complicaciones posquirúrgicas, la necesidad y duración de la hospitalización, la tasa de reconsulta y la mortalidad asociada a los procedimientos en este grupo de edad son similares a las observadas en estudios con población menor de 80 años.


Abstract Introduction: fourth age patients have been cared for in the electrophysiology unit of a tertiary care hospital in Manizales, Caldas; however, there is little clarity in the literature regarding therapeutic conduct in this age group. We present our experience of care and intervention in patients over the age of 80 between September 20, 2017 and October 7, 2019. Methods: a longitudinal cohort study in which data was collected from a chart review. Telephone follow up was performed three and six months after the procedure. Patients over the age of 80 who had undergone any procedure in the electrophysiology lab were included. Patients without follow up information were excluded. Results: data were collected on 75 patients undergoing a procedure: 62.7% of the patients were men, ages ranged from 80 to 95, and 32.7% of the patients had a diagnosis of sinus dysfunction. The most prevalent comorbidity was arterial hypertension (92%). The most frequently performed procedure was dual chamber pacemaker implantation. The median hospital stay was one day. Seventy percent of the patients had a medium or low risk according to the CHA2DS2-VASc scale. Over a six-month period, a 4% cumulative incidence of complications was found, with 8% reconsultation and 1.3% mortality. Conclusions: postsurgical complications, the need for and length of hospitalization, the rate of reconsultation and the mortality associated with procedures in this age group are similar to those seen in studies of populations under 80 years old.


Subject(s)
Humans , Male , Female , Aged, 80 and over , Aged, 80 and over , Pacemaker, Artificial , Patients , Sick Sinus Syndrome , Therapeutic Approaches , Medical Records , Cardiac Electrophysiology
13.
Rev. bras. cir. cardiovasc ; 36(1): 18-24, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1155788

ABSTRACT

Abstract Introduction: It is challenging to diagnose syncope in patients with pacemakers. Because these patients have increased morbidity and mortality risks, they require immediate attention to determine the causes in order to provide appropriate treatment. This study aimed to investigate the causes and predictive factors of syncope as well as the methods used to diagnose syncope in cardiac pacemaker patients. Methods: Patients with pacemakers implanted owing to sinus node disease or atrioventricular block were evaluated with standardized questionnaires, endocavitary electrograms, and other tests based on the suspected causes of syncope. Mann-Whitney U tests were used to analyze continuous variables and Chi-squared or Fisher's exact tests were used for categorical variables. Logistic regression was used for multivariate analyses. Statistical significance was P<0.05. Results: The study included 95 patients with pacemakers: 47 experienced syncope in the last 12 months and 48 did not. Of the 100 documented episodes of syncope, 48.9% were vasovagal syncopes, 17% had cardiac-related causes, 10.6% had unknown causes, and 8.5% had pacemaker failure. The multivariate analysis showed that a New York Heart Association (NYHA) Functional Class II was a significant factor for developing syncope (P<0.01). Conclusion: While the most common type of syncope in pacemaker patients was neurally mediated, it is important to perform detailed evaluations in this population as the causes of syncope can be life-threatening. The best diagnostic methods were stored electrogram analysis and the tilt table test. NYHA Functional Class II patients were found to have a higher risk for syncope.


Subject(s)
Humans , Pacemaker, Artificial , Syncope, Vasovagal/diagnosis , Syncope, Vasovagal/etiology , Syncope, Vasovagal/therapy , Atrioventricular Block , Syncope/diagnosis , Syncope/etiology , Tilt-Table Test
14.
Article in English | WPRIM | ID: wpr-880670

ABSTRACT

OBJECTIVES@#To compare the left ventricular systolic function between the 1eft bundle branch pacing (LBBP) and right ventricular septum pacing (RVSP) in patients with pacemaker dependence by three-dimensional speckle tracking imaging (3D-STI).@*METHODS@#A total of 65 patients with atrioventricular block (AVB) (Mobitz type II second-degree AVB, high-degree AVB, or third-degree AVB), who underwent permanent cardiac pacing implantation including 32 patients receiving LBBP (LBBP group) and 33 patients receiving RVSP (RVSP group) from June 2018 to June 2019,were enrolled in this study. These patients met the following inclusion criterion: pre-operative left ventricular ejection fraction (LVEF)>50% and ventricular pacing rate>40% at 6-month programming follow-up; and the patients underwent echocardiography at pre-operation and 6 months after operation. The 3D-STI was used to obtain global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS).@*RESULTS@#All the patients in the LBBP group and the RVSP group had normal LVEF, there was no significant difference between the 2 group (@*CONCLUSIONS@#For patients with pacemaker dependence and normal LVEF at pre-operation, the cardiac function in the LBBP group is not significantly better than that in the RVSP group in short term follow-up. But in terms of physiologic pacing and long-term cardiac function protection, the 1eft bundle branch pacing is an optimal pacing mode.


Subject(s)
Bundle of His , Cardiac Pacing, Artificial , Humans , Pacemaker, Artificial , Stroke Volume , Ventricular Function, Left , Ventricular Septum/diagnostic imaging
16.
Arq. bras. cardiol ; 115(6): 1114-1124, dez. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1152928

ABSTRACT

Resumo Fundamento Remoção de cabos-eletrodos de dispositivos cardíacos eletrônicos implantáveis (DCEI) é procedimento pouco frequente e sua realização exige longo treinamento profissional e infraestrutura adequada. Objetivos Avaliar a efetividade e a segurança da remoção de cabos-eletrodos de DCEI e determinar fatores de risco para complicações cirúrgicas e mortalidade em 30 dias. Métodos Estudo prospectivo com dados derivados da prática clínica. De janeiro/2014 a abril/2020, foram incluídos, consecutivamente, 365 pacientes submetidos à remoção de cabos-eletrodos, independentemente da indicação e técnica cirúrgica utilizada. Os desfechos primários foram: taxa de sucesso do procedimento, taxa combinada de complicações maiores e morte intraoperatória. Os desfechos secundários foram: fatores de risco para complicações intraoperatórias maiores e morte em 30 dias. Empregou-se análise univariada e multivariada, com nível de significância de 5%. Resultados A taxa de sucesso do procedimento foi de 96,7%, sendo 90,1% de sucesso completo e 6,6% de sucesso clínico. Complicações maiores intraoperatórias ocorreram em 15 (4,1%) pacientes. Fatores preditores de complicações maiores foram: tempo de implante dos cabos-eletrodos ≥ 7 anos (OR= 3,78, p= 0,046) e mudança de estratégia cirúrgica (OR= 5,30, p= 0,023). Classe funcional III-IV (OR= 6,98, p<0,001), insuficiência renal (OR= 5,75, p=0,001), infecção no DCEI (OR= 13,30, p<0,001), número de procedimentos realizados (OR= 77,32, p<0,001) e complicações maiores intraoperatórias (OR= 38,84, p<0,001) foram fatores preditores para mortalidade em 30 dias. Conclusões Os resultados desse estudo, que é o maior registro prospectivo de remoção de cabos-eletrodos da América Latina, confirmam a segurança e a efetividade desse procedimento no cenário da prática clínica real. (Arq Bras Cardiol. 2020; 115(6):1114-1124)


Abstract Background Transvenous lead extraction (TLE) of cardiac implantable electronic devices (CIED) is an uncommon procedure and requires specialized personnel and adequate facilities. Objectives To evaluate the effectiveness and safety of the removal of CIED leads and to determine risk factors for surgical complications and mortality in 30 days. Methods Prospective study with data derived from clinical practice. From January 2014 to April 2020, we included 365 consecutive patients who underwent TLE, regardless of the indication and surgical technique used. The primary outcomes were: success rate of the procedure, combined rate of major complications and intraoperative death. Secondary outcomes were: risk factors for major intraoperative complications and death within 30 days. Univariate and multivariate analysis were used, with a significance level of 5%. Results Procedure success rate was 96.7%, with 90.1% of complete success and 6.6% of clinical success. Major intraoperative complications occurred in 15 (4.1%) patients. Predictors of major complications were: lead dwelling time ≥ 7 years (OR = 3.78, p = 0.046) and change in surgical strategy (OR = 5.30, p = 0.023). Functional class III-IV (OR = 6.98, p <0.001), renal failure (OR = 5.75, p = 0.001), CIED infection (OR = 13.30, p <0.001), number of procedures performed (OR = 77.32, p <0.001) and major intraoperative complications (OR = 38.84, p <0.001) were predictors of 30-day mortality. Conclusions The results of this study, which is the largest prospective registry of consecutive TLE procedures in Latin America, confirm the safety and effectiveness of this procedure in the context of real clinical practice. (Arq Bras Cardiol. 2020; 115(6):1114-1124)


Subject(s)
Humans , Pacemaker, Artificial/adverse effects , Defibrillators, Implantable/adverse effects , Prospective Studies , Retrospective Studies , Treatment Outcome , Device Removal
17.
Texto & contexto enferm ; 29: e20180486, Jan.-Dec. 2020. tab
Article in English | LILACS, BDENF | ID: biblio-1059147

ABSTRACT

ABSTRACT Objective: to assess the health-related quality of life of patients with a permanent cardiac pacemaker. Method: descriptive, observational, cross-sectional study conducted in the arrhythmia outpatient unit of a university hospital located in the interior of São Paulo, Brazil. The consecutive and non-probabilistic sample was composed of both sexes, older than 29 years old, having a pacemaker for at least one month. Those lacking the cognitive condition to answer the questionnaires, as well as those with dyspnea, weakness, or fatigue at the time the instruments were applied, or with an implantable cardioverter defibrillator, were excluded. The generic instrument Medical Outcomes Study 36 - Item Short-Form Health Survey, composed of 36 questions distributed into eight domains along with the specific instrument Assessment of Quality of Life and Related Events, composed of 20 questions distributed into three domains, were used to assess health-related quality of life. Results: 88 patients participated; most were men, had a partner, and were aged 64.3 (±13) years old on average. The domains from the Medical Outcomes Study 36 that obtained the highest means, that is, were the best-rated, were Social Functioning (78.1; ±26.8) and Emotional Well-Being (68.2; ±23.9), while the lowest means were obtained by Physical Health (48.2; ±41.4) and Physical Functioning (58.5; ±27.9). In regard to the Assessment of Quality of Life and Related Events, the Arrhythmia domain had the highest mean and best quality of life (78.2; ±20.7), while the lowest mean was Dyspnea (71.1; ±26.8). Conclusion: the patients gave the highest health-related quality of life ratings in regard to mental domains and the lowest ratings for the physical domains.


RESUMEN Objetivo: evaluar la calidad de vida relacionada con la salud de pacientes con marcapaso cardíaco definitivo. Método: estudio observacional descriptivo, transversal, realizado en el ambulatorio de arritmia de un hospital universitario del interior del estado de Sao Paulo. La muestra consecutiva y no probabilística estuvo constituida de pacientes de los dos sexos, mayores de 18 años, con marcapaso hace, por lo menos, un mes. Fueron excluidos los que no presentaron condiciones cognitivas para responder a los cuestionarios, como también aquellos que presentaron disnea, debilidad y fatiga, en el momento de la aplicación de los instrumentos; y, también aquellos con desfibrilador cardioversor implantable. Para la evaluación de la calidad de vida relacionada con la salud, se utilizó el instrumento genéricoMedical Outcomes Study 36 - Item Short-Form Health Survey, compuesto por 36 preguntas distribuidas en ocho dominios, y el instrumento específicoAssessment of Quality of Life and Related Events, compuesto por 20 preguntas distribuidas en tres dominios. Resultados: participaron 88 pacientes, la mayoría del sexo masculino y con compañero, con edad media de 64,3 (±13) años. Los dominios que presentaron mayores medias, así como mejores evaluaciones, fueron Aspectos Sociales (78,1; ±26,8) y Salud Mental (68,2; ±23,9), y las menores fueron Aspectos Físicos (48,2; ±41,4) y Capacidad Funcional (58,5; ±27,9), referentes alMedical OutcomesStudy 36. En cuanto al Assessment of Quality of Life and Related Events, el dominio de mayor media y mejor calidad de vida fue Arritmia (78,2; ±20,7), y el de menor, Disnea (71,1; ±26,8). Conclusión: los pacientes presentaron mejores evaluaciones da calidad de vida relacionada con la salud en los dominios mentales y peores en los dominios físicos.


RESUMO Objetivo: avaliar a qualidade de vida relacionada à saúde de pacientes com marca-passo cardíaco definitivo. Método: estudo observacional descritivo, transversal, realizado no ambulatório de arritmia de um hospital universitário do interior paulista. Amostra consecutiva e não probabilística foi constituída de pacientes de ambos os sexos, maiores de 18 anos, com marca-passo há pelo menos um mês. Foram excluídos os que não apresentaram condições cognitivas para responder aos questionários, como também aqueles que apresentaram dispneia, fraqueza e fadiga no momento da aplicação dos instrumentos e com cardioversor desfibrilador implantável. Para a avaliação da qualidade de vida relacionada à saúde, utilizou-se o instrumento genérico Medical Outcomes Study 36 - Item Short-Form Health Survey, composto por 36 questões distribuídas em oito domínios, e o instrumento específico Assessment of Quality of Life and Related Events, composto por 20 questões distribuídas em três domínios. Resultados: participaram 88 pacientes, a maioria do sexo masculino e com companheiro, com a média de idade de 64,3 (±13). Os domínios que apresentaram maiores médias, assim como melhores avaliações, foram Aspectos Sociais (78,1; ±26,8) e Saúde Mental (68,2; ±23,9), e as menores foram em Aspectos Físicos (48,2; ±41,4) e Capacidade Funcional (58,5; ±27,9), referentes ao Medical Outcomes Study 36. Quanto ao Assessment of Quality of Life and Related Events, o domínio de maior média e melhor qualidade de vida foi Arritmia (78,2; ±20,7), e o de menor, Dispneia (71,1; ±26,8). Conclusão: os pacientes apresentaram melhores avaliações da qualidade de vida relacionada à saúde nos domínios mentais e piores nos domínios físicos.


Subject(s)
Humans , Adult , Pacemaker, Artificial , Arrhythmias, Cardiac , Postoperative Care , Quality of Life , Nursing
18.
Arq. bras. cardiol ; 115(6): 1178-1179, dez. 2020.
Article in English, Portuguese | LILACS | ID: biblio-1152949

ABSTRACT

O manejo de dispositivos cardíacos eletrônicos implantáveis de pacientes que evoluem a óbito tem sido motivo de controvérsia. Em nosso meio, não há recomendações uniformes, estando baseadas exclusivamente em protocolos institucionais e em costumes regionais. Quando o cadáver é submetido para cremação, além de outros cuidados, recomenda-se a retirada do dispositivo devido ao risco de explosão e dano do equipamento crematório. Principalmente no contexto da pandemia causada pelo SARS-Cov-2, a orientação e organização de unidades hospitalares e serviços funerários é imprescindível para minimizar o fluxo de pessoas em contato com fluidos corporais de indivíduos falecidos por COVID-19. Nesse sentido, a Sociedade Brasileira de Arritmias Cardíacas elaborou este documento com orientações práticas, tendo como base publicações internacionais e recomendação emitida pelo Conselho Federal de Medicina do Brasil.


The management of cardiac implantable electronic devices after death has become a source of controversy. There are no uniform recommendations for such management in Brazil; practices rely exclusively on institutional protocols and regional custom. When the cadaver is sent for cremation, it is recommended to remove the device due to the risk of explosion and damage to crematorium equipment, in addition to other precautions. Especially in the context of the SARS-CoV-2 pandemic, proper guidance and organization of hospital mortuary facilities and funeral services is essential to minimize the flow of people in contact with bodily fluids from individuals who have died with COVID-19. In this context, the Brazilian Society of Cardiac Arrhythmias has prepared this document with practical guidelines, based on international publications and a recommendation issued by the Brazilian Federal Medical Council.


Subject(s)
Humans , Pacemaker, Artificial , Autopsy/methods , Defibrillators, Implantable , Cardiac Resynchronization Therapy Devices , COVID-19
20.
Rev. bras. cir. cardiovasc ; 35(5): 713-721, Sept.-Oct. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137324

ABSTRACT

Abstract Objective: To modify the chronic atrial fibrillation of atrial tachycardia pacing in beagles with a homemade pacemaker placed outside the body and to evaluate connective tissue growth factor and fibrosis of atrial tissue in our modified atrial tachycardia pacing beagle model. Methods: Twelve adult beagles of either sex were randomly divided into an atrial tachycardia pacing group and a control group (n=6 in each group). We performed the temporary pacemaker implantation at the right atrial appendage and put the pacemaker into the pocket of dog clothing in the atrial tachycardia pacing group. After eight weeks of atrial tachycardia pacing, the electrocardiography, transthoracic echocardiography, hematoxylin-eosin staining, and Masson's staining of the right atrial appendages were performed along with the immunohistochemistry, quantitative real-time polymerase chain reaction, and Western blot analysis of connective tissue growth factor, collagen I, and collagen III. Results: In the atrial tachycardia pacing group, atrial fibrillation was induced in five beagles (83.3%); the left atrium enlarged significantly; more canines had mitral regurgitation; and the Masson's staining, quantitative real-time polymerase chain reaction, and Western blot results demonstrated more obvious fibrosis of the left atrium. Conclusion: The modified beagle model of atrial fibrillation using a right atrium pacemaker outside the body was effective, increased connective tissue growth factor and collagen I messenger ribonucleic acid overexpression, and induced atrial fibrosis.


Subject(s)
Humans , Animals , Dogs , Pacemaker, Artificial , Atrial Fibrillation/etiology , Disease Models, Animal , Heart Atria/diagnostic imaging
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