ABSTRACT
BACKGROUND: Center volume and operator experience/training are important factors impacting outcomes in AFib CA. Setting for RF delivery (power, duration, and contact force) associated with better outcomes remains to be determined. METHODS: This is an observational, longitudinal, and retrospective study. All consecutive procedures performed between December 12, 2013, and March 9, 2023, in a low-volume private center in Latin America were analyzed. Procedure characteristics and outcomes were compared between STD and vHPSD. RESULTS: Two hundred ten procedures were performed on 194 patients. Median annual number of procedures was 19 (7-29). Median age was 62 (52-68), and majority were male (71%). Median procedure duration was 155 (125-195) min, mean fluoroscopy time 32.8 ± 15 min and mean fluoroscopy dose 373.5 ± 208.9 mGray. Median follow-up was 27 months, significantly longer in STD compared with vHPSD group (43 [31-68] vs. 13 [8-19], respectively; P ≤ 0.001). The recurrence rate was 33.2% and major complications 8.6%. Compared with STD, vHPSD resulted in a significantly shorter procedure duration (125 vs. 180 min, P ≤ 0.001), shorter fluoroscopy time (22.7 ± 9.5 vs. 39.2 ± 14.3 min, P ≤ 0.001), and lower fluoroscopy dose (283.8 ± 161.1 vs. 438.3 ± 216.1 mGray, P ≤ 0.001). No long-term recurrence difference was observed when the follow-up periods were comparable. No difference in complication rate was observed (8.5% vs. 8.6%, P = 0.988). CONCLUSIONS: Outcomes in AFib CA in a Latin American low-volume private center can be considered acceptable, with efficacy and safety similar to those reported in the literature. Compared with STD ablation, vHPSD showed higher efficiency with similar efficacy and safety.
ABSTRACT
La miocardiopatía de Tako-tsubo (MT) y síndrome de QT largo congénito (SQTLc) son dos entidades que presentan un retardo de la repolarización cardíaca y su asociación ha sido publicada en reportes de casos. Presentamos el caso de una paciente de 55 años, con antecedentes de SQTLc, que ingresó a nuestro hospital por dolor precordial, luego de un evento estresante, diagnosticándose MT. Evolucionó con prolongación del intervalo QT en el electrocardiograma, persistiendo luego de la externación, sin presentar episodios de arritmias ventriculares ni síncope
Takobsubo cardiomyopathy (TC) and congenital long QT syndrome (LQTS) are two entities that present a delay of cardiac repolarization and their association has been published in case reports. We present the case of a 55-year-old female patient with medical history of congenital LQTS, who was admitted to our hospital due to precordial pain after a stressful event and TC was diagnosed. She evolves with QT interval prolongation on the ECG that remains after the externalization, without presenting any episodes of ventricular arrhythmia or syncope
A cardiomiopatia de Tako-tsubo (CT) e a síndrome do QT longo congênito (SQTLc) são duas entidades que apresentam um atraso da repolarização cardíaca e sua associação foi publicada em relatos de casos. Apresentamos o caso de uma paciente de 55 anos de idade com história médica de SQTLc, admitida em nosso hospital devido a dor precordial após um evento estressante, com diagnóstico de CT. Ela evolui com prolongamento do intervalo QT no ECG que permanece após a externalização, sem apresentar nenhum episódios de arritmias ventriculares ou síncope
Subject(s)
Romano-Ward Syndrome , Takotsubo CardiomyopathyABSTRACT
La muerte súbita cardíaca en deportistas genera un gran impacto social y familiar, afortunadamente su incidencia es baja. En atletas menores de 35 años las causas más frecuentes son las anomalías genéticas y las miocardiopatías. Presentamos el caso de un paciente masculino de 17 años que presentó muerte súbita reanimada mientras realizaba actividad física. El electrocardiograma post animación evidenció una injuria subepicárdica en cara anterior, encontrándose en la cinecoronariografía como único hallazgo, la existencia de un puente muscular en tercio medio de la arteria descendente anterior.
Cardiac arrest in athletes has a high impact in family and society, fortunately its incidence is low. In athletes younger than 35 years old the most frequent causes are genetic anomalies and cardiomyopathies. We report the case of a 17 years old male patient who presented cardiac arrest and reanimation while doing physical activity. The post-reanimation electrocardiogram showed a subepicardial injury in the anterior face, detecting in cinecoronariography as only finding the presence of myocardial bridging in the middle third of anterior descending artery.
A parada cardíaca em atletas tem um alto impacto na família e na sociedade, felizmente sua incidência é baixa. Em atletas menores de 35 anos as causas mais freqüentes são anomalias genéticas e cardiomiopatías. Relatamos o caso de um paciente do sexo masculino de 17 anos de idade que apresentou parada cardíaca e reanimação durante atividade física. O eletrocardiograma pós-reanimação mostrou lesão subepicárdica na face anterior, detectar na cinecoronariografia como apenas encontrar a presença de ponte miocárdica no terço médio da artéria descendente anterior.
Subject(s)
Myocardial Ischemia , Death, Sudden , Myocardial Bridging , AthletesABSTRACT
La sarcoidosis es una enfermedad inflamatoria crónica que posee una amplia variabilidad de presentaciones clínicas. El compromiso cardíaco de esta patología oscila en el orden del 5%, pudiendo variar desde anormalidades en la conducción hasta la falla cardíaca. Existe poco conocimiento sobre los beneficios de su tratamiento y no hay datos que evalúen la reducción de la mortalidad a largo plazo, por lo que genera este tipo de pacientes un gran desafío para el profesional. A continuación presentamos el caso de un masculino de 37 años con taquicardia ventricular como debut cardiológico de una sarcoidosis.
