Pub Date : 2020-04-16DOI: 10.24207/jca.v32n4.980_pt
Silas dos Santos Galvão Filho
Com o advento dos marcapassos cardíacos há mais de 60 anos, iniciou-se a era da estimulação cardíaca artificial, que mudou a história natural das bradicardias sintomáticas, aumentando significativamente a sobrevida principalmente dos pacientes portadores de bloqueio atrioventricular total.
{"title":"Cardiomiopatia Induzida por Estimulação Cardíaca Artificial","authors":"Silas dos Santos Galvão Filho","doi":"10.24207/jca.v32n4.980_pt","DOIUrl":"https://doi.org/10.24207/jca.v32n4.980_pt","url":null,"abstract":"Com o advento dos marcapassos cardíacos há mais de 60 anos, iniciou-se a era da estimulação cardíaca artificial, que mudou a história natural das bradicardias sintomáticas, aumentando significativamente a sobrevida principalmente dos pacientes portadores de bloqueio atrioventricular total.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45637055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-16DOI: 10.24207/jca.v32n4.111_in
Kamilo Mesquita Dantas, Heitor Tomé Rezende, Antônio Menezes da Silva Junior, H. M. D. R. Sobrinho, Pedro Paulo Clark de Oliveira
Introduction: circulating miRNA were identified as potential biomarkers in cardiac arrhythmias. It is intended to evaluate, in patients with atrial fibrillation (AF), the expression of miRNAs in plasma, their clinical repercussion and their prognostic factor. Materials and Methods: PubMed, Cochrane and Google Scholar platforms were used as a data source. Eligibility criteria: miRNAs as direct biomarkers in the clinical expression of AF; all languages. Last search: 19/09/2019; studies involving other comorbidities were excluded; pharmacological focus; in animals, in patients already submitted to cardiac procedures and review articles. Plasma collection and storage, RNA isolation, data analysis, realtime PCR, miRNA target prediction and statistical analysis were performed in the studies. Results: The studies generated n = 332 patients: with AF and control group. In patients with AF there was an increase in the expression of miR-1266, miR-4279, miR- 892a, miR-3149, miR-155, miR-146b5p, miR-19b and a reduction in miR-3171, miR-3664-5p and miRNA -150. Discussion: it was noted that the regulation of inflammatory mediators, ion channels and cardiac morphophysiology are related to the expression of miRNA. Conclusion: Therefore, the levels of changes in miRNAs may reflect the severity of the clinical and pathophysiological progression of AF, and can be used as predictors of AF.
{"title":"The Clinical Expression and Implication of Plasma miRNAs in Patients with Atrial Fibrillation","authors":"Kamilo Mesquita Dantas, Heitor Tomé Rezende, Antônio Menezes da Silva Junior, H. M. D. R. Sobrinho, Pedro Paulo Clark de Oliveira","doi":"10.24207/jca.v32n4.111_in","DOIUrl":"https://doi.org/10.24207/jca.v32n4.111_in","url":null,"abstract":"Introduction: circulating miRNA were identified as potential biomarkers in cardiac arrhythmias. It is intended to evaluate, in patients with atrial fibrillation (AF), the expression of miRNAs in plasma, their clinical repercussion and their prognostic factor. Materials and Methods: PubMed, Cochrane and Google Scholar platforms were used as a data source. Eligibility criteria: miRNAs as direct biomarkers in the clinical expression of AF; all languages. Last search: 19/09/2019; studies involving other comorbidities were excluded; pharmacological focus; in animals, in patients already submitted to cardiac procedures and review articles. Plasma collection and storage, RNA isolation, data analysis, realtime PCR, miRNA target prediction and statistical analysis were performed in the studies. Results: The studies generated n = 332 patients: with AF and control group. In patients with AF there was an increase in the expression of miR-1266, miR-4279, miR- 892a, miR-3149, miR-155, miR-146b5p, miR-19b and a reduction in miR-3171, miR-3664-5p and miRNA -150. Discussion: it was noted that the regulation of inflammatory mediators, ion channels and cardiac morphophysiology are related to the expression of miRNA. Conclusion: Therefore, the levels of changes in miRNAs may reflect the severity of the clinical and pathophysiological progression of AF, and can be used as predictors of AF.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42941389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-16DOI: 10.24207/jca.v32n4.982_in
Enrique Indalécio Pachón Mateos, José Carlos Pachón Mateos Mateos, Ricardo Carneiro Amarante, Carlos Thiene Cunha Pachón, Tasso Júlio Lobo, Tomás Guillermo Santillana Peña, Juán Carlos Zerpa Acosta, Juán Carlos Pachón Mateos, Felipe Ortêncio, Christian Higuti
Atrial fibrillation is the most prevalent arrhythmia in the world population. Despite the use of antiarrhythmics, it is difficult to control clinically, causing symptoms and mainly generating risk of a thromboembolic event. Since 1998, by means of radiofrequency ablation, the treatment of atrial fibrillation has completely changed, but together with this important evolution complications from this ablative treatment technique have also started. In addition to the pulmonary vein stenosis caused by the ablation and later corrected with the change in the technique, atrioesophageal fistulas appeared due to the application of radiofrequency in the posterior wall of the left atrium. This wall is very close (0.5 cm onaverage) to the esophagus, which facilitates the formation of the fistula that leads to the death of almost 100% of the affected patients, despite the various treatment measurements already developed. To avoid this serious complication, several authors have created techniques to protect the esophagus including its mechanical deviation to a region opposite to the radiofrequency application, taking advantage of its mobility and easiness of handling. The mechanical deviation of the esophagus has proven to be the simplest, cheapest and most efficient way to protect this organ from radiofrequency thermal damage during atrial fibrillation ablation.
{"title":"Prevention of Esophageal Damage During Ablation of Atrial Fibrillation by the Esophagus Mechanical Deviation","authors":"Enrique Indalécio Pachón Mateos, José Carlos Pachón Mateos Mateos, Ricardo Carneiro Amarante, Carlos Thiene Cunha Pachón, Tasso Júlio Lobo, Tomás Guillermo Santillana Peña, Juán Carlos Zerpa Acosta, Juán Carlos Pachón Mateos, Felipe Ortêncio, Christian Higuti","doi":"10.24207/jca.v32n4.982_in","DOIUrl":"https://doi.org/10.24207/jca.v32n4.982_in","url":null,"abstract":"Atrial fibrillation is the most prevalent arrhythmia in the world population. Despite the use of antiarrhythmics, it is difficult to control clinically, causing symptoms and mainly generating risk of a thromboembolic event. Since 1998, by means of radiofrequency ablation, the treatment of atrial fibrillation has completely changed, but together with this important evolution complications from this ablative treatment technique have also started. In addition to the pulmonary vein stenosis caused by the ablation and later corrected with the change in the technique, atrioesophageal fistulas appeared due to the application of radiofrequency in the posterior wall of the left atrium. This wall is very close (0.5 cm onaverage) to the esophagus, which facilitates the formation of the fistula that leads to the death of almost 100% of the affected patients, despite the various treatment measurements already developed. To avoid this serious complication, several authors have created techniques to protect the esophagus including its mechanical deviation to a region opposite to the radiofrequency application, taking advantage of its mobility and easiness of handling. The mechanical deviation of the esophagus has proven to be the simplest, cheapest and most efficient way to protect this organ from radiofrequency thermal damage during atrial fibrillation ablation.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46253738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ricardo L. De Castro Junior, N. Lima, Stela Sampaio Vitorino
Brugada syndrome (BrS) has been described as an arrhythmic disorder characterized by ST elevation with successive negative T wave in the right precordial leads. Patients are at risk for sudden cardiac death (SCD) due to ventricular fibrillation (VF). This specific electrocardiogram (ECG) pattern can sometimes be confused with ST elevation myocardial ischemia. This report shows a patient who presented with chest pain and had an ECG compatible with Brugada. An ischemic workup was performed, and acute coronary syndrome was ruled out. He had a final diagnosis of BrS and was discharged home after the placement of an automatic defibrillator.
{"title":"Brugada Pattern Mimicking Myocardial Acute Infarct","authors":"Ricardo L. De Castro Junior, N. Lima, Stela Sampaio Vitorino","doi":"10.24207/jca.v33i1.3352","DOIUrl":"https://doi.org/10.24207/jca.v33i1.3352","url":null,"abstract":"Brugada syndrome (BrS) has been described as an arrhythmic disorder characterized by ST elevation with successive negative T wave in the right precordial leads. Patients are at risk for sudden cardiac death (SCD) due to ventricular fibrillation (VF). This specific electrocardiogram (ECG) pattern can sometimes be confused with ST elevation myocardial ischemia. This report shows a patient who presented with chest pain and had an ECG compatible with Brugada. An ischemic workup was performed, and acute coronary syndrome was ruled out. He had a final diagnosis of BrS and was discharged home after the placement of an automatic defibrillator.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46513061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-17DOI: 10.24207/jca.v32n3.067_in
José Carlos Pachon Mateos, Enrique I Pachón Mateos, Christian Higuti, Tomas Guilhermo Santillana Peña, Tasso Júlio Lobo, Carlos Thiene Cunha Pachón, Juán Carlos Pachón Mateos, Juán Carlos Zerpa Acosta, Felipe Ortêncio, R. Amarante
The vasovagal syncope is the most frequent cause of transient loss of consciousness, especially in young people without significant heart disease. The malignant cardioinhibitory form is caused by abrupt and intense vagal reflex with or without defined triggers. Refractory cases to preventive measures and pharmacological handling has been treated with definitive pacemaker implantation. Besides showing questionable results, pacemaker implantation is highly rejected by young patients. In the late 1990s, we proposed specific vagal denervation by catheter ablation and spectral mapping, for paroxysmal AF, functional bradyarrhythmias and severe cases of malignant cardioinhibitory syncope giving rise to cardioneuroablation. Recently, many authors worldwide have been reproducing the cardioneuroablation results where elimination or significant reduction of the vagal response were observed, which abolished symptoms in more than 75% of patients followed up to 14 years, without complications. Therefore, cardioneuroablation has shown to be a real therapeutic option in malignant syncope cardioinhibitory and in any exclusive vagal mediated bradyarrhythmia without the need for pacemaker implantation.
{"title":"Cardioneuroablation: Catheter Vagal Denervation as a New Therapy for Cardioinhibitory Syncope","authors":"José Carlos Pachon Mateos, Enrique I Pachón Mateos, Christian Higuti, Tomas Guilhermo Santillana Peña, Tasso Júlio Lobo, Carlos Thiene Cunha Pachón, Juán Carlos Pachón Mateos, Juán Carlos Zerpa Acosta, Felipe Ortêncio, R. Amarante","doi":"10.24207/jca.v32n3.067_in","DOIUrl":"https://doi.org/10.24207/jca.v32n3.067_in","url":null,"abstract":"The vasovagal syncope is the most frequent cause of transient loss of consciousness, especially in young people without significant heart disease. The malignant cardioinhibitory form is caused by abrupt and intense vagal reflex with or without defined triggers. Refractory cases to preventive measures and pharmacological handling has been treated with definitive pacemaker implantation. Besides showing questionable results, pacemaker implantation is highly rejected by young patients. In the late 1990s, we proposed specific vagal denervation by catheter ablation and spectral mapping, for paroxysmal AF, functional bradyarrhythmias and severe cases of malignant cardioinhibitory syncope giving rise to cardioneuroablation. Recently, many authors worldwide have been reproducing the cardioneuroablation results where elimination or significant reduction of the vagal response were observed, which abolished symptoms in more than 75% of patients followed up to 14 years, without complications. Therefore, cardioneuroablation has shown to be a real therapeutic option in malignant syncope cardioinhibitory and in any exclusive vagal mediated bradyarrhythmia without the need for pacemaker implantation.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45527290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-17DOI: 10.24207/jca.v32i3.075_in
Júlio Cota Pacheco, Beatriz Silvestre Knust, J. Paes Leme, Hercilia S. C. A. Santos
The tracings obtained in long-term electrocardiographic monitoring by the Holter system.
动态心电图系统在长期心电图监测中获得的描记图。
{"title":"What is the Diagnosis?","authors":"Júlio Cota Pacheco, Beatriz Silvestre Knust, J. Paes Leme, Hercilia S. C. A. Santos","doi":"10.24207/jca.v32i3.075_in","DOIUrl":"https://doi.org/10.24207/jca.v32i3.075_in","url":null,"abstract":"The tracings obtained in long-term electrocardiographic monitoring by the Holter system.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41915491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-17DOI: 10.24207/jca.v32i3.984_in
J. T. Medeiros de Vasconcelos
Atrial fibrillation is currently a central issue in the universe of cardiac arrhythmias. The increase in life expectancy that brought a substantial increase in its prevalence in the general population1 implied a marked deepening in the understanding of its electrophysiological mechanisms, in the identification of determining factors or potentiation of its occurrence and obviously in the development of effective strategies of treatment and prevention of its complications. Since the classic study of Wijffels et al., published in 1995 (Atrial Fibrillation Begets Atrial Fibrillation)2 which experimentally demonstrated that atrial frequencies artificially imposed to the atrial myocardium imply marked electrophysiological changes determining the very occurrence of atrial fibrillation, it became clear that once arrhythmia is initiated it potentiates its own occurrence and a constant process of feedback, whose final outcome over time is the installation of arrhythmia in a permanent form. However, for atrial fibrillation to occur, the presence of an adequate electrophysiological environment is necessary, consequent to the presence of several elements that aggress the atrial myocardium under the electrical and structural aspects.
{"title":"Obesity and Atrial Fibrillation","authors":"J. T. Medeiros de Vasconcelos","doi":"10.24207/jca.v32i3.984_in","DOIUrl":"https://doi.org/10.24207/jca.v32i3.984_in","url":null,"abstract":"Atrial fibrillation is currently a central issue in the universe of cardiac arrhythmias. The increase in life expectancy that brought a substantial increase in its prevalence in the general population1 implied a marked deepening in the understanding of its electrophysiological mechanisms, in the identification of determining factors or potentiation of its occurrence and obviously in the development of effective strategies of treatment and prevention of its complications. Since the classic study of Wijffels et al., published in 1995 (Atrial Fibrillation Begets Atrial Fibrillation)2 which experimentally demonstrated that atrial frequencies artificially imposed to the atrial myocardium imply marked electrophysiological changes determining the very occurrence of atrial fibrillation, it became clear that once arrhythmia is initiated it potentiates its own occurrence and a constant process of feedback, whose final outcome over time is the installation of arrhythmia in a permanent form. However, for atrial fibrillation to occur, the presence of an adequate electrophysiological environment is necessary, consequent to the presence of several elements that aggress the atrial myocardium under the electrical and structural aspects.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47550124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-17DOI: 10.24207/jca.v32i3.075_pt
Júlio Cota Pacheco, Beatriz Silvestre Knust, Jonas Paes Leme, Hercilia S. C. A. Santos
Os traçados obtidos em monitorização eletrocardiográfica de longa duração pelo sistema Holter.
动态心电图系统长期心电图监测获得的轨迹。
{"title":"Qual o Diagnóstico?","authors":"Júlio Cota Pacheco, Beatriz Silvestre Knust, Jonas Paes Leme, Hercilia S. C. A. Santos","doi":"10.24207/jca.v32i3.075_pt","DOIUrl":"https://doi.org/10.24207/jca.v32i3.075_pt","url":null,"abstract":"Os traçados obtidos em monitorização eletrocardiográfica de longa duração pelo sistema Holter.","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48141677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-17DOI: 10.24207/jca.v32i3.986_in
José Tarcísio Medeiros d Vasconcelos
One image and tracings were obtained during the para-Hisian stimulation maneuver in an electrophysiological study. The question is: is there any retrograde nodal or extranodal conduction behavior?
{"title":"What is the Diagnosis?","authors":"José Tarcísio Medeiros d Vasconcelos","doi":"10.24207/jca.v32i3.986_in","DOIUrl":"https://doi.org/10.24207/jca.v32i3.986_in","url":null,"abstract":"One image and tracings were obtained during the para-Hisian stimulation maneuver in an electrophysiological study. The question is: is there any retrograde nodal or extranodal conduction behavior?","PeriodicalId":33934,"journal":{"name":"Journal of Cardiac Arrhythmias","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47541679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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