ABSTRACT
PURPOSE: Over the last years, pediatric electrophysiology (EP) has evolved as a consolidated subspecialty of pediatric cardiology. In the USA, Canada, and Europe, there is a clear picture of the status of pediatric EP, but the situation in Latin America is largely unknown. METHODS: A descriptive cross-sectional observational study was performed. A survey was conducted by the Latin American Heart Rhythm Society in Spanish and Portuguese to assess the status of development of pediatric EP across Latin American countries. RESULTS: There are physicians practicing pediatric EP in 11 Latin American countries. The scope of the practices includes clinical and non-invasive EP as well as performing invasive EP procedures. All the current pediatric EP interventions are performed in most of Latin American countries. CONCLUSIONS: Pediatric electrophysiology is present as a subspecialty in half of the countries in Latin America, and all the current electrophysiology procedures and therapeutic technologies are available in most Latin American countries.
Subject(s)
Cardiac Electrophysiology , Cardiology , Child , Cross-Sectional Studies , Humans , Latin America/epidemiology , Surveys and QuestionnairesABSTRACT
A estimulação cardíaca na população pediátrica possui peculiaridades que merecem destaque. O tamanho dos pacientes, o crescimento somático, as alterações morfológicas das cardiopatias congênitas e o longo período de estimulação são alguns aspectos que devem ser observados nos pacientes que necessitam de implante destes dispositivos. As técnicas de implante epicárdica e endocavitária são opções que devem ser consideradas a cada caso. A escolha pelos implantes epicárdicos esta mais relacionada aos pacientes de pequeno peso, com "shunts" intracavitários ou com anatomia desfavorável. Havendo condições, a opção por implantes endocavitários ou com anatomia desfavorável. Havendo condições, a opção por implantes endocavitários é feita de forma preferencial, principalmente por que esta via apresenta melhores evoluções em longo prazo.
Subject(s)
Humans , Child , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/diagnosis , Cardiac Pacing, Artificial/methods , Cardiac Pacing, Artificial , Pacemaker, Artificial , Risk FactorsABSTRACT
A arritmia cardíaca pode ocorrer em qualquer idade, do feto ao adulto. As diferenças fisiológicas acarretam um comportamento da arritmia e da ação das drogas peculiares em cada faixa etária. A decisão terapêutica na população se torna difícil. Este artigo tem como objetivo enfatizar as características específicas na infância para o tratamento farmacológico das arritmias.
Subject(s)
Humans , Child , Tachycardia, Supraventricular/complications , Tachycardia/complications , Tachycardia/diagnosis , Therapeutics/methods , Therapeutics , Child , Pharmaceutical Preparations/administration & dosage , Pharmaceutical Preparations/adverse effectsABSTRACT
A presença de ritmo não sinusal e arritmias características da doença sinusal é indício de mau prognóstico em pacientes com circulação de Fontan. O objetivo deste artigo é descrever o uso de algoritmo para minimizar o estímulo ventricular em um paciente pediátrico. Uma criança de oito anos, com cardiopatia cianótica complexa e circulação de Fontan, apresentou taquicardia ventricular (32% dos batimentos) mediada por bradicardia e disfunção ventricular...
Subject(s)
Humans , Male , Heart Defects, Congenital , Pacemaker, Artificial , Pulmonary Artery , Echocardiography , Fontan Procedure/methodsABSTRACT
OBJECTIVE: The purpose was to determine the sensitivity, the specificity and a year-long risk of subsequent cardiovascular events in patients with low, intermediate and high risk prognostic Duke treadmill score (DTS) in comparison with the presence (or not) of the myocardial perfusion defects on radionuclide images. METHODS: A prospective study, with 173 consecutive patients with 02 or more risk factors to coronary artery disease (CAD), who underwent to exercise single photon - emission computed tomographic myocardial perfusion images using technetium-99m tetrophosmin (SPECT) and treadmill test (with DTS), from one neighbourhood of Curitiba city, between January 2003 and February 2004, were followed up for cardiac-cause mortality and major cardiac events. Follow-up was performed in 13+/- 1 months and in 162 patients was complete. RESULTS: The DTS mean those patients with cardiac event (18) over a year was -0.27 (95% CI= -3.97 to +3.91) and those free cardiac event patients (144) was +4.92 (95% CI= +4.03 to +5.81), with p<0.00069. The DTS sensitivity was 72.22% and the SPECT sensitivity was 77.78%, with no significant difference p=0.21. The DTS specificity was 54.17% and the SPECT specificity was 88.19%, with p<0.0001. The cumulative proportion free-events (Kaplan-Meier) curves demonstrated that 94% those patients with low-risk DTS remained free-cardiac events. In contrast, all high-risk DTS had adverse cardiac events. Those patients with intermediate-risk DTS had 15% of cardiac event over a year. CONCLUSIONS: The DTS was as sensitivity as SPECT in determine a year risk for CAD. Those patients with DTS <-0.27 had high-risk cardiac event.
Subject(s)
Coronary Artery Disease/diagnostic imaging , Exercise Test , Heart/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Tomography, Emission-Computed, Single-Photon , Coronary Artery Disease/etiology , Epidemiologic Methods , Female , Humans , Male , Middle Aged , PrognosisABSTRACT
Os autores relatam o caso de uma criança com 37 dias de vida, submetida a cirurgia de correção de coarctação de aorta e ligadura do canal arterial, que evoluiu no 3Ý dia de pós-operatório com bradicardia sinusal severa e escape juncional bradicárdico. Foi instalado marcapasso atrial transesofágico, com estabilidade hemodinâmica. Após 5 dias de marcapasso provisório, a paciente evoluiu com recuperação da função sinusal, recebendo alta, sem sequelas, no 14Ý dia de internação. São discutidas as indicações e as vantagens da estimulação atrial transesofágica em crianças
