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1.
Arq. bras. cardiol ; 117(5): 1010-1015, nov. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1350021

ABSTRACT

Resumo Fundamento: A doença pelo novo coronavírus (COVID-19) está associada a manifestações clínicas cardiovasculares, incluindo a ocorrência de arritmias cardíacas. Objetivos: Avaliar a incidência de arritmias cardíacas (taquiarritmia atrial, bradiarritmia e taquicardia ventricular sustentada) e de parada cardiorrespiratória (PCR) em uma coorte de pacientes internados com COVID-19 em hospital universitário terciário. Métodos: Estudo de coorte retrospectivo realizado por meio de revisão dos registros de prontuário médico. Para comparação entre os grupos, foi considerado como estatisticamente significativo valor de P < 0,05. Resultados: Foram incluídos 241 pacientes consecutivos com diagnóstico de COVID-19 (idade média, 57,8 ± 15,0 anos; 51,5% homens; 80,5% de raça branca) e 35,3% com necessidade de ventilação mecânica invasiva (VM). A mortalidade geral foi de 26,6%, sendo de 58,8% entre aqueles em VM. Arritmias cardíacas ocorreram em 8,7% dos pacientes, sendo a mais comum taquiarritmia atrial (76,2%). Pacientes com arritmias apresentaram maior mortalidade, 52,4% versus 24,1% (p=0,005). Em análise multivariada, apenas a presença de insuficiência cardíaca foi associada a maior risco de arritmias ( hazard ratio , 11,9; IC 95%: 3,6-39,5; p<0,001). Durante a internação, 3,3% dos pacientes foram atendidos em PCR, com predomínio de ritmos não chocáveis. Todos os atendidos em PCR evoluíram com óbito durante a internação. Conclusão: A incidência de arritmias cardíacas em pacientes internados com COVID-19 em hospital terciário brasileiro foi de 8,7%, sendo a mais comum taquiarritmias atrial. A presença de insuficiência cardíaca foi associada a maior risco de arritmias. Pacientes com COVID-19 atendidos em PCR apresentam elevada mortalidade.


Abstract Background: The coronavirus disease 2019 (COVID-19) is associated with cardiovascular clinical manifestations, including cardiac arrhythmias. Objective: To assess the incidence of cardiac arrhythmias (atrial tachyarrhythmia, bradyarrhythmia, and sustained ventricular tachycardia) and cardiac arrest (CA) in a cohort of patients hospitalized with COVID-19 in a tertiary university-affiliated hospital. Methods: Cohort study with retrospective analysis of electronic medical records. For comparison between groups, a value of p <0.05 was considered statistically significant Results: We included 241 consecutive patients diagnosed with COVID-19 (mean age, 57.8 ± 15.0 years; 51.5% men; 80.5% white), 35.3% of whom received invasive mechanical ventilation (MV). The overall mortality was 26.6%, being 58.8% among those on MV. Cardiac arrhythmias were identified in 8.7% of the patients, the most common being atrial tachyarrhythmia (76.2%). Patients with arrhythmias had higher mortality (52.4% versus 24.1%, p = 0.005). On multivariate analysis, only the presence of heart failure (HF) was associated with a higher risk of arrhythmias (hazard ratio, 11.9; 95% CI: 3.6-39.5; p <0.001). During hospitalization, 3.3% of the patients experienced CA, with a predominance of non-shockable rhythms. All patients experiencing CA died during hospitalization. Conclusions: The incidence of cardiac arrhythmias in patients admitted with COVID-19 to a Brazilian tertiary hospital was 8.7%, and atrial tachyarrhythmia was the most common. Presence of HF was associated with an increased risk of arrhythmias. Patients with COVID-19 experiencing CA have high mortality.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Tachycardia, Ventricular/etiology , Tachycardia, Ventricular/epidemiology , COVID-19 , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/epidemiology , Retrospective Studies , Risk Factors , Cohort Studies , Hospital Mortality , SARS-CoV-2 , Middle Aged
2.
Arch. cardiol. Méx ; 90(3): 341-346, Jul.-Sep. 2020.
Article in Spanish | LILACS | ID: biblio-1131053

ABSTRACT

Resumen Objetivo: Analizar el comportamiento de posibles causas predisponentes de muerte súbita (MS) intrahospitalaria luego de un infarto agudo de miocardio (IMA) en registros cubanos. Material y método: Se realizó una búsqueda de registros clínicos de pacientes con IMA en Cuba en las bases de datos de revistas nacionales, Scientific Library On-line (ScieLO) y Medline. Se priorizaron los artículos publicados desde 2016 para ser incluidos. Se definió como muerte súbita aquélla secundaria a arritmias ventriculares malignas (TV y FV), así como los pacientes con rotura cardíaca y actividad eléctrica sin pulso o asistolia como forma de presentación. Con posterioridad se evaluó la relación de este parámetro con la aparición de muerte súbita en 710 pacientes del Registro de Síndromes Coronarios Agudos (RESCUE). Resultados: En el contexto extrahospitalario, más de la mitad de las muertes súbitas cardíacas son secundarias a un infarto agudo de miocardio. En el hospital, la mortalidad en Cuba por IMA es homogénea. Sólo los centros con intervencionismo coronario escapan a este fenómeno. Aunque no del todo letales, las arritmias ventriculares malignas se relacionan con un peor pronóstico y su prevalencia no es homogénea en los registros revisados. Conclusiones: La muerte súbita luego de infarto agudo de miocardio será aún en Cuba una de las principales causas de muerte en los pacientes de fase aguda.


Abstract Objective: To analyze possible predisposing causes of in hospital sudden cardiac death (SCD) after an acute myocardial infarction (IMA) in Cuban registries. Material and methods: A search of clinical records of patients with IMA in Cuba was performed in the databases of national journals, Scientific Library On-line and Medline. Those articles published since 2016 were prioritized for inclusion. Sudden death is defined as that secondary to malignant ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation) as well as patients with cardiac rupture with pulseless electrical activity or asystole as a form of presentation. Subsequently, the relationship of this parameter with the occurrence of sudden death was evaluated in 710 patients from the Registry of Acute Coronary Syndromes (RESCUE). Results: In the out-of-hospital setting, more than half of SCD are secondary to an IMA. Once in the hospital, mortality in Cuba from IMA is homogeneous. Only centers with coronary interventionism escape this phenomenon. Although not totally lethal, the presence of malignant ventricular arrhythmias is associated with a worse prognosis and its prevalence is not homogeneous in the reviewed records. Conclusions: Sudden death after IMA will continue to be one of the main causes of death of patients in the acute phase in Cuba.


Subject(s)
Humans , Death, Sudden, Cardiac/etiology , Myocardial Infarction/mortality , Ventricular Fibrillation/mortality , Ventricular Fibrillation/epidemiology , Registries , Death, Sudden, Cardiac/epidemiology , Tachycardia, Ventricular/mortality , Tachycardia, Ventricular/epidemiology , Cuba , Hospitals , Myocardial Infarction/epidemiology
3.
Arq. bras. cardiol ; 102(5): 489-494, 10/06/2014. tab
Article in Portuguese | LILACS | ID: lil-711095

ABSTRACT

Fundamento: O tratamento com células-tronco nas diversas cardiomiopatias pode estar relacionado ao aumento nas arritmias. Objetivos: Determinar se a injeção intracoronária de células-tronco em portadores de cardiomiopatia chagásica está associada ao aumento da incidência de arritmias ventriculares, comparado ao Grupo Controle. Métodos: Estudo de coorte retrospectivo, que avaliou o prontuário de 60 pacientes que participaram de estudo transversal anterior. Foram coletados os seguintes dados: idade, sexo, medicamentos utilizados e variáveis do Holter, que demonstraram presença de arritmia complexa. O Holter foi realizado em quatro momentos: randomização, 2, 6 e 12 meses de seguimento. O Grupo Controle recebeu tratamento medicamentoso e injeção intracoronaria de placebo e o Grupo Estudo tratamento medicamentoso e implante autólogo de células-tronco. Resultados: Não houve diferença entre os Grupos Controle e Estudo nos critérios de arritmia analisados. Na análise intragrupo, foi encontrada diferença com significância entre os exames de Holter do Grupo Estudo na variável total de extrassístoles ventriculares comparada à basal, sendo entre de p = 0,014 entre Holter na randomização e Holter aos 2 meses, p = 0,004 entre Holter na randomização e Holter aos 6 meses, e p = 0,014 entre Holter na randomização e Holter aos 12 meses. A variável taquicardia ventricular não sustentada entre Holter na randomização e Holter aos 6 meses apresentou p = 0,036. Conclusão: A injeção intracoronária de células-tronco não aumentou a incidência de arritmia ventricular complexa em pacientes com cardiomiopatia chagásica, comparada ao Grupo Controle. .


Background: Treatment with stem cells in several cardiomyopathies may be related to the increase in arrhythmias. Objectives: To determine whether intracoronary injection of stem cells in patients with Chagas cardiomyopathy is associated with increased incidence of ventricular arrhythmias, compared to the Control Group. Methods: A retrospective cohort study that evaluated the medical records of 60 patients who participated in a previous cross-sectional study. The following data were collected: age, gender, drugs used and Holter variables that demonstrated the presence of arrhythmias. Holter was performed in four stages: randomization, 2, 6 and 12 months segments. The Control Group received medical treatment and intracoronary injection of placebo and the Study Group had drug treatment and autologous stem cell implant. Results: There was no difference between Control Group and Study Group when analyzing the arrhythmia criteria. In the intra-group analysis, significant difference was found between the Holter tests of the Study Group for the variable total ventricular premature beats when compared with baseline, with p = 0.014 between Holter at randomization and Holter at 2 months, p = 0.004 between Holter at randomization and Holter at 6 months, and p = 0.014 between Holter at randomization and Holter at 12 months. The variable non-sustained ventricular tachycardia between Holter at randomization and Holter at 6 months showed p = 0.036. Conclusion: The intracoronary injection of stem cells did not increase the incidence of ventricular arrhythmias in patients with Chagas cardiomyopathy compared to the Control Group. .


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Chagas Cardiomyopathy/therapy , Stem Cell Transplantation/adverse effects , Tachycardia, Ventricular/etiology , Bone Marrow Transplantation , Brazil/epidemiology , Cross-Sectional Studies , Chagas Cardiomyopathy/complications , Electrocardiography, Ambulatory , Incidence , Reference Values , Retrospective Studies , Statistics, Nonparametric , Time Factors , Tachycardia, Ventricular/epidemiology
4.
PAFMJ-Pakistan Armed Forces Medical Journal. 2009; 59 (4): 450-454
in English | IMEMR | ID: emr-125461

ABSTRACT

The objective of this study was to identify the frequency and clinical patterns of arrhythmias in anterior and inferior myocardial infarction [MI]. A descriptive study. This study was conducted at critical care unit of Combined Military Hospital Kharian cantonment from January 2006 to December 2006. Hundred patients were included in the study that fulfilled the required criteria. They underwent detailed history taking and systemic examination. Patients were monitored through cardiac monitors and serial ECG recordings were taken especially if any rhythm disturbances were observed or if the patient suffered any symptom, till the time of discharge from the hospital. The relevant information was entered into a specially designed pro forma. All the data collected through the pro forma was analyzed through SPSS version 11 in terms of frequency, percentages and proportions. Premature ventricular contractions [PVCs] were the most common rhythm disturbance followed by ventricular tachycardia [VT]. Both were more common in anterior myocardial infarction [MI] than inferior MI. Bradyarrhythmias were more common with inferior MI. PVCs usually manifested with chest pain, VT was accompanied by palpitations and dyspnoea. Atrioventricular [AV] blocks clinically presented as syncope. PVCs are the most common rhythm disturbance after anterior and inferior MI. VT and ventricular fibrillation [VF] are frequent in anterior while bradyarrhythmias are common with inferior MI


Subject(s)
Humans , Male , Female , Adult , Myocardial Infarction , Arrhythmias, Cardiac/diagnosis , Heart Block/epidemiology , Tachycardia, Ventricular/epidemiology , Electrocardiography
5.
Sudan Journal of Medical Sciences. 2008; 3 (4): 325-331
in English | IMEMR | ID: emr-90452

ABSTRACT

Ventricular arrhythmias [VAS], including ventricular tachycardia [VT], ventricular fibrillation [VF] and Brady-arrhythmias, are life-threatening complications of acute myocardial infarction [MI]. To study the incidence of ventricular arrhythmias, brady-arrhythmias and Sudden Cardiac Death [SCD] in Sudanese patients with acute MI. This is a prospective cross sectional, hospital based study, conducted at Elshaab Teaching Hospital Khartoum Sudan. One Hundred Sudanese patients with acute MI were enrolled in the study in the period between August 2006 and December 2006. A questionnaire was constructed in sections to address the different aspect of the study group. ECG Monitor was used to confirm the complication in every patient. Of the study group forty seven [47%] patients were 55-65 years old, twenty eight [28%] were more than 65 years old and twenty five [25%] were less than 55 years old. Sixty nine [69%] were males. Twenty patients [20%] developed complications [ventricular arrhythmias [VAS], Brady-arrhythmias and SCD]. The incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death following acute myocardial infarction were significantly high in Sudanese patients. The increased incidence is even in all age groups. DM, smoking and past history of IHD are the commonest associated risk factors. Thrombolysis is under used and had no significant impact


Subject(s)
Humans , Male , Female , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires/statistics & numerical data , Electrocardiography/statistics & numerical data , Thrombolytic Therapy/statistics & numerical data , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/epidemiology , Bradycardia/etiology , Bradycardia/epidemiology , Ventricular Fibrillation/etiology , Ventricular Fibrillation/epidemiology , Tachycardia, Ventricular/etiology , Tachycardia, Ventricular/epidemiology , Smoking/complications , Incidence
6.
Article in English | IMSEAR | ID: sea-41601

ABSTRACT

BACKGROUND: The incidence of arrhythmic complications in Thai patients with acute coronary syndromes (ACS) has not been previously reported. The present study results will serve as the local database for future studies. OBJECTIVE: To evaluate the incidence of arrhythmic complications in ASC in Thai patients and to identify factors that may affect arrhythmia complications in ACS patients. MATERIAL AND METHOD: Data collected from 9,373 patients from the Thai acute coronary syndrome registry (TACSR) were analyzed. This registry includes patients who presented with ACS including ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA), within 14 days from the symptoms onset. RESULTS: 395 (4.2%) patients with an ACS presented after cardiac arrest. These patients were noted to have significantly higher in-hospital mortality (50.1%). The incidence of serious cardiac arrhythmia complications in the TACSR was 16.6%. Among them, 62.7% were sustained VT/VE 31.5% had second or third degree AV block, and 5.8% has both VT/VF and AV Block. The incidence of VT was higher in the younger age group, while AV block and arrhythmic death were higher in the older aged patients. Arrhythmias complicating ACS were associated with increased mortality risk. Congestive heart failure (CHF) within the first 48 hours, current use of tobacco and cardiac troponin elevation were associated with significantly higher arrhythmic complications during hospitalization. CONCLUSION: Arrhythmias complicating ACS were associated with higher in hospital mortality. CHF within the first 48 hr, current tobacco use and cardiac troponin elevation were associated with significantly higher arrhythmic complications.


Subject(s)
Acute Coronary Syndrome/complications , Acute Disease , Adult , Aged , Atrioventricular Block/epidemiology , Databases as Topic , Epidemiologic Studies , Female , Hospital Mortality , Humans , Incidence , Male , Middle Aged , Registries , Risk Factors , Tachycardia, Ventricular/epidemiology , Thailand/epidemiology , Troponin , Ventricular Fibrillation/epidemiology
7.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2005; 15 (2): 68-70
in English | IMEMR | ID: emr-71481

ABSTRACT

To describe the etiology and outcome in patients with ventricular tachycardia in our patient population. A descriptive study. The study was conducted at the Aga Khan University Hospital from November 2002 to October 2003. Subjects and We enrolled 58 patients who presented to the emergency room with clinical and electrocardiographic evidence of ventricular tachycardia [VT] and/or who developed it during the inpatient stay at the Aga Khan University Hospital. Medical records were retrieved through the computerized data retrieval system. Patients above 18 years of age were included. Those with a pacemaker or who developed VT during electrophysiological testing were excluded. A pre-designed proforma was filled for all patients who fulfilled the inclusion criteria. All patients were worked up for etiological causes of ventricular tachycardia. Outcomes in the form of death or discharge were recorded. There were 58 patients who suffered ventricular tachycardias during the study period. These included 70.7% [42] males and 29.3% [16] females. Mean age of the patients was 57.06 +/- 11.84 years. Emergency room admissions accounted for 55.2% and ventricular tachycardia was seen in 44.8% during the inpatient stay. Unresponsiveness was the presenting symptom in 25.9%, chest pain in 24.1%, palpitations in 13.8% and ghabrahat in 12.1% patients. Myocardial ischemia was seen in 43.5% of the patients while 23.2% had cardiomyopathy, followed by 33.3% miscellaneous. Out of the patients who had myocardial ischemia [43.5%], 76.6% had non-ST elevation myocardial infarction, 20% patients had ST elevation myocardial infarction and 3.3% had unstable angina. Hemodynamic instability was noted in 50%, who subsequently required defibrillation. The mortality among these patients with VT was 13.7%. Myocardial ischemia was most commonly seen in patients with ventricular tachycardia in our group of patients. Ventricular tachycardia is associated with a significant mortality of 13.7%


Subject(s)
Humans , Male , Female , Tachycardia, Ventricular/epidemiology , Tachycardia, Ventricular/etiology , Death, Sudden, Cardiac , Cardiomyopathy, Dilated/complications , Myocardial Ischemia/complications
8.
Heart Views. 1999; 1 (6): 217-222
in English | IMEMR | ID: emr-50840

ABSTRACT

Sustained ventricular tachyarrhythmias [VT] such as monomorphic or polymorphic ventricular tachycardia and ventricular fibrillation represent the most dreadful arrhythmic events that can complicate the postoperative course of coronary artery bypass grafting [CABG]. The perioperative factors that are potentially associated with the onset of post-CAGB sustained VT have not been deeply investigated. Hence, the aim of our paper was to identify which perioperative variables predict post-CABG VT occurrence. One hundred fifty-two consectivity patients who underwent CABG surgery at our institution between September and December 1997 comprised the study population. Post-CABG VT occurred in 13 [8.5%] out of 152 patients [6 cases of monomorphic ventricular tachycardia and 7 cases of ventricular fibrillation]. Using university analysis, VT patients were compared with those who remained in sinus rhythm [SR]. VT patients were significantly younger [54.8 +/- 6.6 vs. 60.1 +/- 8.8, p=0.038], had more severe coronary artery disease [CAD] [NO. of diseased vessels 2.92 +/- 0.3 vs 2.45 +/- 0.7, p=0.023], had a higher incidence of three-vessel CAD [91.7% vs 57.3%, p=0.043], and received a greater number of CABG[s] [% of patients teceiving three or more CABG[s] 76.9% vs. 38.8%, p=0.018]. VT patients were found to developed intra-or operative myocardial infarction more frequently [total CK> 1000 76.9% vs. 38%, p=0.016; and MB-CK> normal range 72.7% vs 30.7%, p=0.014], had a higher incidence of electrolyte derangement [84.6% vs 45.6%, p=0.017] and more severe hemodynamic impairment [need of IABP 23% vs 2.9%, p=0.009]. At multivariate analysis, total CK> 1000, postoperative electrolyte imbalance, the need of three or more CABG[s] and use of IABP were found to be independent correlates for VT. Post-CABG VT seem to be related to the pre-existence of severe underlying coronary artery disease and to triggering factors such as acute ischemia, electrolyte disorders, and a sudden hemodynamic impairment that might precipitate the onset of VT


Subject(s)
Humans , Male , Female , Ventricular Fibrillation/etiology , Tachycardia, Ventricular/etiology , Postoperative Complications , Ventricular Fibrillation/epidemiology , Tachycardia, Ventricular/epidemiology , Causality
10.
Arq. bras. cardiol ; 58(3): 175-9, mar. 1992. ilus, tab
Article in Portuguese | LILACS | ID: lil-122177

ABSTRACT

Objetivo - Analisar o início de surtos de taquicardias ventriculares polimórficas, com a finalidade de determinar a importância deste parâmetro no contexto clínico-eletrofisiológico. Métodos - Foram analisados um total de 124 inícios de episódios, em gravaçöes de Holter, em 6 pacientes. Quatro faziam uso de quinidina e diuréticos e 2 somente diuréticos. Determinaram-se os valores em ms, dos dois ciclos imediatamente precedentes ao início dos surtos e dos ciclos indutores (ciclos A, B e C). Analisaram-se as características da repolarizaçäo ventricular e os intervalos QT ou QTU desses ciclos, bem como os valores de QT fora dos episódios. Resultados - Em 105 ocasiöes (84%), os inícios de surtos foram pausas-dependentes; em 12 ocasiöes (10%) ocorreram sem pausas e a partir de uma fusäo ventricular e em 7 momentos (6%) sem pausas e a partir de um encurtamento súbito dos ciclos C (fenômeno R + T). Os surtos pausas-dependentes somente foram observados nos pacientes em uso de sulfato de quindina e diuréticos e os näo dependentes de pausas nos pacientes em uso somente de duréticos. Todos apresentavam intervalos QTU prolongados fora dos surtos, havendo uma relaçäo linear entre a amplitude das ondas U dos ciclos C e a duraçäo dos ciclos A e B. Conclusäo - Frente aos resultados, os seguintes aspectos foram acentuados, a partir da análise do início de surtos de taquicardias ventriculares polimórficas; pode-se diferenciar formas típicas de torsades de pointers (pausa-dependente) e atípicas. As primeiras ocorrem provavelmente em funçäo da presença de atividade de disparo (pós-potenciais precoces). As formas atípicas melhor se enquadrariam a presença de mecanismos reentrantes ou hiperautomáticos. Somente nas formas típicas, haveria benefício no uso de MP artificial provisório para tratamento, pela regularizaçäo dos ciclos cardíacos que este procedimento produz


Subject(s)
Humans , Male , Female , Middle Aged , Cardiac Pacing, Artificial , Heart Rate/physiology , Tachycardia, Ventricular/epidemiology , Aged, 80 and over , Electrocardiography , Electrophysiology , Precipitating Factors , Long QT Syndrome/physiopathology , Tachycardia, Ventricular/physiopathology
11.
In. Figuero F., Carlos. Temas de Urgencias Quirurgicas y Clinicas. Quito, Pfizer, s.f. p.213-9.
Monography in Spanish | LILACS | ID: lil-178353
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