RESUMO
Brugada syndrome (BrS) may cause a spectrum of symptoms from asymptomatic patients to those who experience cardiac arrest and sudden cardiac death. The diagnosis is confirmed after observation of type I Brugada pattern on the electrocardiogram. Following the diagnosis, risk stratification can help select therapeutic options. Cascade screening should be started to find other family members with BrS. We present a 41-year-old woman diagnosed with BrS, and cascade screening of her relatives unveiled a pedigree of BrS among their family.
RESUMO
Although percutaneous coronary intervention [PCI] improves outcomes compared to thrombolysis, a substantial number of ST-elevation myocardial infarction [STEMI] patients do not achieve optimal myocardial reperfusion. This study was designed to evaluate factors related to suboptimal myocardial reperfusion after primary PCI in patients with STEMI. Totally, 155 patients [124 men; mean age = 56.6 +/- 11.03 years, range = 31- 85 years] with STEMI undergoing primary PCI were retrospectively studied. Additionally, the relationships between the occurrence of reperfusion failure and variables such as age, sex, cardiac risk factors, family history, Body Mass Index, time of symptom onset, ejection fraction, previous PCI, coronary artery bypass graft surgery or previous myocardial infarction, and angiographic data were analyzed. Procedural success was 97.1% and complete ST resolution occurred in 43.2%. Age; cardiac risk factors; family history; body mass index; previous MI, coronary artery bypass graft surgery, or PCI; and use of thrombectomy device and GP2b/3a inhibitor were not the determining factors [p value > 0.05]. According to our multivariate analysis, time of symptom onset [OR [95% CI]: 045 [0.2 to 0.98]; p value = 0.044] and ejection fraction [OR [95% CI]:0.37 [0.26 to .091]; p value = 0.050] had reverse and male gender had direct significant associations with failed reperfusion [OR [95% CI]: 0.34 [0.11 to 1.08]; p value = 0.068]. More degrees of ST resolution occurred when the right coronary artery was the culprit vessel [p value = 0.001]. The presence of more than three cardiac risk factors was associated with failed reperfusion [p value = 0.050]. Considering the initial risk profile of patients with acute STEMI, including time of symptom onset and ejection fraction, as well as the accumulation of cardiac risk factors in a given patient, we could predict failed myocardial reperfusion to design a more aggressive therapeutic strategy
Assuntos
Humanos , Masculino , Feminino , Reperfusão Miocárdica , Fatores de Risco , Intervenção Coronária Percutânea , AngioplastiaRESUMO
The signal-averaged electrocardiograph is a noninvasive method to evaluate the presence of the potentials generated by tissues activated later than their usual timing in the cardiac cycle. The purpose of this study was to demonstrate the correlation between the filtered QRS duration obtained via the signal-averaged electrocardiography and left ventricular dimensions and volumes and then to compare it with the standard electrocardiography. We included patients with advanced systolic left ventricular dysfunction [ejection fraction = 35%]. All the patients underwent surface twelve-lead electrocardiography, signal-averaged electrocardiography, and echocardiography. The study included 86 patients with a mean age of 54.66 +/- 13.23 years. The mean left ventricular ejection fraction was 18.31 +/- 5.49%; the mean QRS duration was 0.14 +/- 0.02 sec; and 52% of the patients had left bundle branch block. The mean filtered QRS duration was 145.87 +/- 24.89 ms. Our data showed a significant linear relation between the filtered QRS duration and left ventricular end-systolic volume, left ventricular end-diastolic volume, left ventricular end-systolic diameter, and left ventricular end-diastolic diameter; the correlation coefficient was, however, not good. There was no significant correlation between the QRS duration and left ventricular diameters and volumes. The filtered QRS duration has a better correlation with left ventricular dimensions and volumes than does the QRS duration in the standard electrocardiography