Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.02.011
Paulo Dias Costa , João Pedro Bessa , Mariana Canelas Pais , Daniela Ferreira-Santos , Fernando Montenegro Sá , Matilde Monteiro-Soares , António Hipólito-Reis , Mário Martins Oliveira , Pedro Pereira Rodrigues
Background
Cardiac resynchronization therapy (CRT) is an established therapeutic option for heart failure, but despite careful selection around 30% of the patients still do not respond to this therapy. The standard electrocardiogram (ECG) is a practical and inexpensive tool to assess potential responders to CRT but with conflicting evidence regarding the value of different ECG parameters. As such, we conducted a systematic review of real-world studies to assess the value of pre-implantation standard ECG parameters in predicting response to CRT.
Methods
We searched on PubMed, Scopus, and Web of Knowledge online databases to identify analytic studies and synthesized results through evidence tables.
Results
Sixty-two eligible articles were included in this review. Traditional predictors of response were QRS duration ≥150 ms and the presence of left bundle branch block morphology. Contemporary ECG parameters, such as the presence of QRS notching or fragmentation, the S wave assessment, the time to intrinsicoid deflection (ID) in lateral leads, and a lead one ratio ≥12 also showed great potential in assessing response to CRT.
Conclusions
This review highlights the promising capability of the standard ECG in predicting response to CRT, particularly when using more contemporary predictors, while emphasizing the necessity for further research to validate the prognostic value of these predictors.
背景：心脏再同步化治疗（CRT）是心力衰竭的既定治疗选择，但尽管经过仔细选择，仍有大约30%的患者对这种治疗没有反应。标准心电图（ECG）是一种实用且廉价的工具，用于评估对CRT的潜在反应，但关于不同ECG参数的值存在相互矛盾的证据。因此，我们对现实世界的研究进行了系统回顾，以评估植入前标准心电图参数在预测CRT反应中的价值。方法：检索PubMed、Scopus、Web of Knowledge等在线数据库，识别分析性研究，并通过证据表综合结果。结果：本综述纳入了62篇符合条件的文章。传统的反应预测指标为QRS持续时间≥150ms和存在左束支阻滞（LBBB）形态。当代心电图参数，如QRS缺口或碎片的存在、S波评估、侧导联到本征偏转（ID）的时间、导联比(LOR)≥12，也显示出对CRT反应的巨大潜力。结论：本综述强调了标准心电图在预测CRT反应方面的良好能力，特别是在使用更现代的预测指标时，同时强调了进一步研究以验证这些预测指标的预后价值的必要性。
{"title":"Prediction of response to cardiac resynchronization therapy using electrocardiographic criteria: A systematic review","authors":"Paulo Dias Costa , João Pedro Bessa , Mariana Canelas Pais , Daniela Ferreira-Santos , Fernando Montenegro Sá , Matilde Monteiro-Soares , António Hipólito-Reis , Mário Martins Oliveira , Pedro Pereira Rodrigues","doi":"10.1016/j.repc.2025.02.011","DOIUrl":"10.1016/j.repc.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac resynchronization therapy (CRT) is an established therapeutic option for heart failure, but despite careful selection around 30% of the patients still do not respond to this therapy. The standard electrocardiogram (ECG) is a practical and inexpensive tool to assess potential responders to CRT but with conflicting evidence regarding the value of different ECG parameters. As such, we conducted a systematic review of real-world studies to assess the value of pre-implantation standard ECG parameters in predicting response to CRT.</div></div><div><h3>Methods</h3><div>We searched on PubMed, Scopus, and Web of Knowledge online databases to identify analytic studies and synthesized results through evidence tables.</div></div><div><h3>Results</h3><div>Sixty-two eligible articles were included in this review. Traditional predictors of response were QRS duration ≥150 ms and the presence of left bundle branch block morphology. Contemporary ECG parameters, such as the presence of QRS notching or fragmentation, the S wave assessment, the time to intrinsicoid deflection (ID) in lateral leads, and a lead one ratio ≥12 also showed great potential in assessing response to CRT.</div></div><div><h3>Conclusions</h3><div>This review highlights the promising capability of the standard ECG in predicting response to CRT, particularly when using more contemporary predictors, while emphasizing the necessity for further research to validate the prognostic value of these predictors.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 561-576"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.03.006
Sérgio Bravo Baptista , Gustavo Pires de Morais , Luís Almeida Morais , João Costa , Hugo Vinhas , Gustavo Campos , Pedro Carrilho Ferreira , Nélson Vale , Filipe Seixo , Miguel Santos , Cristina Martins , Diogo Rodrigues Brás , André Alexandre , Luís Raposo
Introduction and objectives
Diabetes is a major determinant of ischemic events after percutaneous coronary intervention (PCI). In a nationwide prospective registry, antiplatelet and glucose-lowering treatment regimens, and two-year clinical outcomes were studied in unselected patients with type 2 diabetes undergoing coronary stent implantation. The current analysis describes the population's baseline characteristics and the prescription patterns of anti-thrombotic and glucose-lowering drugs.
Methods
Between January and November 2021, 1000 patients were enrolled in 12 Portuguese hospitals. In addition to clinical and procedural-related variables, thrombotic (DAPT score) and bleeding risks (PRECISE DAPT) were estimated, and medication (including planned duration of dual antiplatelet therapy) were recorded.
Results
Inclusion rate was relatively high (68.6%) among all eligible patients during the study period (mean age 68±10 years-old, and 70% of male gender). The indication for PCI was an acute coronary syndrome in 58% of cases and 63% had 2–3 vessel coronary artery disease (SYNTAX score 15.6±10.7; mean stent length and diameter 26.3±14.8 and 3.0±1.2 mm, respectively). Of patients not on oral anticoagulation, only 49.8% received potent P2Y12 inhibitors; overall recommendation for shorter DAPT regimens (<6 months,) was 26.5% and did not differ according to low vs. high bleeding risk (24.6% vs. 29.7%; p<0.125). In those also under anticoagulation, 62.6% received a recommendation for <30-day regimens, or no DAPT at all (13.6%). Prolonged DAPT (>12 months) was planned at baseline in 0.7% of the whole cohort and 1.2% of ACS patients. PCI complexity (but not CAD extent) was associated with DAPT duration. Self-reported duration of diabetes was >6 years in 57% (HbA1c 7.6±1.7%) and 12% had known microangiopathy at inclusion. SGLT2 inhibitors (28%) and GLP-1 analogues (3%) were used seldom at admission.
Conclusions
Standard six-to-12-month antiplatelet regimens were the most widely used, largely with acetylsalicylic acid and clopidogrel. DAPT duration was mostly related to PCI complexity and oral-anticoagulation. Metabolic control was off-target and guideline-directed treatment for diabetes was underused at admission (clinicaltrials.gov NCT04481997).
{"title":"Anti-thrombotic and glucose lowering therapy in diabetic patients with coronary artery disease undergoing PCI with stent implantation: A prospective multicenter observational study on prescription patterns and clinical outcomes. Baseline inclusion data of the ARTHEMIS registry","authors":"Sérgio Bravo Baptista , Gustavo Pires de Morais , Luís Almeida Morais , João Costa , Hugo Vinhas , Gustavo Campos , Pedro Carrilho Ferreira , Nélson Vale , Filipe Seixo , Miguel Santos , Cristina Martins , Diogo Rodrigues Brás , André Alexandre , Luís Raposo","doi":"10.1016/j.repc.2025.03.006","DOIUrl":"10.1016/j.repc.2025.03.006","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Diabetes is a major determinant of ischemic events after percutaneous coronary intervention (PCI). In a nationwide prospective registry, antiplatelet and glucose-lowering treatment regimens, and two-year clinical outcomes were studied in unselected patients with type 2 diabetes undergoing coronary stent implantation. The current analysis describes the population's baseline characteristics and the prescription patterns of anti-thrombotic and glucose-lowering drugs.</div></div><div><h3>Methods</h3><div>Between January and November 2021, 1000 patients were enrolled in 12 Portuguese hospitals. In addition to clinical and procedural-related variables, thrombotic (DAPT score) and bleeding risks (PRECISE DAPT) were estimated, and medication (including planned duration of dual antiplatelet therapy) were recorded.</div></div><div><h3>Results</h3><div>Inclusion rate was relatively high (68.6%) among all eligible patients during the study period (mean age 68±10 years-old, and 70% of male gender). The indication for PCI was an acute coronary syndrome in 58% of cases and 63% had 2–3 vessel coronary artery disease (SYNTAX score 15.6±10.7; mean stent length and diameter 26.3±14.8 and 3.0±1.2 mm, respectively). Of patients not on oral anticoagulation, only 49.8% received potent P2Y12 inhibitors; overall recommendation for shorter DAPT regimens (<6 months,) was 26.5% and did not differ according to low vs. high bleeding risk (24.6% vs. 29.7%; p<0.125). In those also under anticoagulation, 62.6% received a recommendation for <30-day regimens, or no DAPT at all (13.6%). Prolonged DAPT (>12 months) was planned at baseline in 0.7% of the whole cohort and 1.2% of ACS patients. PCI complexity (but not CAD extent) was associated with DAPT duration. Self-reported duration of diabetes was >6 years in 57% (HbA1c 7.6±1.7%) and 12% had known microangiopathy at inclusion. SGLT2 inhibitors (28%) and GLP-1 analogues (3%) were used seldom at admission.</div></div><div><h3>Conclusions</h3><div>Standard six-to-12-month antiplatelet regimens were the most widely used, largely with acetylsalicylic acid and clopidogrel. DAPT duration was mostly related to PCI complexity and oral-anticoagulation. Metabolic control was off-target and guideline-directed treatment for diabetes was underused at admission (clinicaltrials.gov <span><span>NCT04481997</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 537-546"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.01.011
Rui Pedro Albuquerque , Hélder Dores , Gonçalo Cunha , Miguel Mendes , Manuel Gonçalves-Pereira
{"title":"Enrollment and adherence in cardiac rehabilitation: Are we neglecting the aging brain?","authors":"Rui Pedro Albuquerque , Hélder Dores , Gonçalo Cunha , Miguel Mendes , Manuel Gonçalves-Pereira","doi":"10.1016/j.repc.2025.01.011","DOIUrl":"10.1016/j.repc.2025.01.011","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 581-583"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.08.001
João Morais
{"title":"Antithrombotic therapy after stent implantation. One size does not fit all","authors":"João Morais","doi":"10.1016/j.repc.2025.08.001","DOIUrl":"10.1016/j.repc.2025.08.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 547-549"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.03.004
Filipa Gerardo , Miguel Santos , Daniel Faria , Maura Nédio , Célia Monteiro , Sérgio Bravo Baptista , Pedro Farto e Abreu
{"title":"Economic evaluation of the impact of generic prasugrel widespread adoption at a national level","authors":"Filipa Gerardo , Miguel Santos , Daniel Faria , Maura Nédio , Célia Monteiro , Sérgio Bravo Baptista , Pedro Farto e Abreu","doi":"10.1016/j.repc.2025.03.004","DOIUrl":"10.1016/j.repc.2025.03.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 589-590"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The effectiveness of cardiac rehabilitation (CR) in improving exercise capacity and quality of life (QoL) in heart failure (HF) is well established. However, it remains underutilized in women. We aimed to compare the adherence and effectiveness of a CR program in women and men with HF.
Methods
This was a prospective single-center study of consecutive 93 HF patients referred to a CR program between September 2019 and July 2021. We defined adherence as the percentage of sessions patients attended. Effectiveness outcomes were changes in peak oxygen uptake (VO2 peak) and QoL measurements before (baseline) and after the CR program (12wk). VO2 peak was assessed by a maximal effort cardiopulmonary exercise testing on a treadmill. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
Results
Among 93 patients, 32.3% were female. Regarding adherence, 84% of patients completed the CR program, and no significant differences were found between groups (p=0.232). The increase in VO2 peak did not differ between genders (p=0.938). A significant reduction in the total, physical and emotional MLHFQ scores in both genders was observed (all p<0.05). There were no significant differences in QoL effectiveness analysis between the groups (all p=NS).
Conclusion
Women with HF adhered to the CR program similarly to men and had a similar increase in VO2 peak, a robust and validated prognostic marker for HF in this setting. Women benefited as much as men in all dimensions of QoL. Together, these data emphasize the need to increase the referral of women with HF to CR programs.
{"title":"Effectiveness of a cardiac rehabilitation program in women with heart failure","authors":"Andreia Campinas , Cristine Schmidt , Maria Isilda Oliveira , Sandra Magalhães , Catarina Gomes , Rita Nogueira-Ferreira , Fernando Ribeiro , Mário Santos","doi":"10.1016/j.repc.2025.02.010","DOIUrl":"10.1016/j.repc.2025.02.010","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The effectiveness of cardiac rehabilitation (CR) in improving exercise capacity and quality of life (QoL) in heart failure (HF) is well established. However, it remains underutilized in women. We aimed to compare the adherence and effectiveness of a CR program in women and men with HF.</div></div><div><h3>Methods</h3><div>This was a prospective single-center study of consecutive 93 HF patients referred to a CR program between September 2019 and July 2021. We defined adherence as the percentage of sessions patients attended. Effectiveness outcomes were changes in peak oxygen uptake (VO<sub>2</sub> peak) and QoL measurements before (baseline) and after the CR program (12wk). VO<sub>2</sub> peak was assessed by a maximal effort cardiopulmonary exercise testing on a treadmill. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).</div></div><div><h3>Results</h3><div>Among 93 patients, 32.3% were female. Regarding adherence, 84% of patients completed the CR program, and no significant differences were found between groups (p=0.232). The increase in VO<sub>2</sub> peak did not differ between genders (p=0.938). A significant reduction in the total, physical and emotional MLHFQ scores in both genders was observed (all p<0.05). There were no significant differences in QoL effectiveness analysis between the groups (all p=NS).</div></div><div><h3>Conclusion</h3><div>Women with HF adhered to the CR program similarly to men and had a similar increase in VO<sub>2</sub> peak, a robust and validated prognostic marker for HF in this setting. Women benefited as much as men in all dimensions of QoL. Together, these data emphasize the need to increase the referral of women with HF to CR programs.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 525-532"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.04.005
Sofia Jacint, Guilherme Portugal, Hélder Santos, Pedro Silva Cunha, Bruno Valente, Ana Lousinha, Ana Sofia Delgado, Rui Cruz Ferreira, Mário Martins Oliveira
Introduction and objectives
Cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL) has improved in recent years, especially with three-dimensional (3D) electroanatomic mapping systems. These tools allow a better understanding of the arrhythmia with higher ablation success rates while reducing radiation exposure. However, most ablation procedures still require varying amounts of fluoroscopy. Our aim was to examine whether fluoroless CTI ablation is effective and safe in reducing AFL recurrence, compared with CTI ablation using fluoroscopy.
Methods
We conducted a retrospective analysis of CTI ablations performed at a tertiary center between December 2010 and December 2022. Patients were divided into two groups: fluoroless and fluoroscopic, according to the use of radiation. Procedural duration, fluoroscopy time (FT), radiofrequency time (RF), acute complications and recurrence rates at one year were analyzed.
Results
A total of 324 CTI ablations were performed. Mean age was 62.3±14.0 years, with 78.1% male patients. The FT was zero in the fluoroless group (n=31), and 7.0±7.0 minutes in the fluoroscopic group (n=293) (p<0.001). There was no statistically significant difference between the two groups, regarding AFL recurrence at one year. RF was shorter in the fluoroless group (8±4 vs. 14±11 minutes, p<0.001). Total time procedure duration was shorter in the fluoroless group (60±20 minutes vs. 99±45 minutes, p<0.001). There were no acute complications.
Conclusion
Fluoroless CTI ablation, avoiding any radiation exposure to the patient and operator, can be performed in patients with typical AFL, without compromising duration, safety or efficacy of the procedure.
{"title":"Fluoroless cavotricuspid isthmus ablation of typical atrial flutter achieves success with shorter radiofrequency and procedural times","authors":"Sofia Jacint, Guilherme Portugal, Hélder Santos, Pedro Silva Cunha, Bruno Valente, Ana Lousinha, Ana Sofia Delgado, Rui Cruz Ferreira, Mário Martins Oliveira","doi":"10.1016/j.repc.2025.04.005","DOIUrl":"10.1016/j.repc.2025.04.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL) has improved in recent years, especially with three-dimensional (3D) electroanatomic mapping systems. These tools allow a better understanding of the arrhythmia with higher ablation success rates while reducing radiation exposure. However, most ablation procedures still require varying amounts of fluoroscopy. Our aim was to examine whether fluoroless CTI ablation is effective and safe in reducing AFL recurrence, compared with CTI ablation using fluoroscopy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of CTI ablations performed at a tertiary center between December 2010 and December 2022. Patients were divided into two groups: fluoroless and fluoroscopic, according to the use of radiation. Procedural duration, fluoroscopy time (FT), radiofrequency time (RF), acute complications and recurrence rates at one year were analyzed.</div></div><div><h3>Results</h3><div>A total of 324 CTI ablations were performed. Mean age was 62.3±14.0 years, with 78.1% male patients. The FT was zero in the fluoroless group (n=31), and 7.0±7.0 minutes in the fluoroscopic group (n=293) (p<0.001). There was no statistically significant difference between the two groups, regarding AFL recurrence at one year. RF was shorter in the fluoroless group (8±4 vs. 14±11 minutes, p<0.001). Total time procedure duration was shorter in the fluoroless group (60±20 minutes vs. 99±45 minutes, p<0.001). There were no acute complications.</div></div><div><h3>Conclusion</h3><div>Fluoroless CTI ablation, avoiding any radiation exposure to the patient and operator, can be performed in patients with typical AFL, without compromising duration, safety or efficacy of the procedure.</div></div>","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 551-555"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.repc.2025.07.001
Renato Margato
{"title":"Rethinking the radiation: Toward a fluoroless future in electrophysiology","authors":"Renato Margato","doi":"10.1016/j.repc.2025.07.001","DOIUrl":"10.1016/j.repc.2025.07.001","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 9","pages":"Pages 557-559"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.repc.2025.06.004
Mário Martins Oliveira
{"title":"Dr. Fernando Matias dos Santos Silva","authors":"Mário Martins Oliveira","doi":"10.1016/j.repc.2025.06.004","DOIUrl":"10.1016/j.repc.2025.06.004","url":null,"abstract":"","PeriodicalId":48985,"journal":{"name":"Revista Portuguesa De Cardiologia","volume":"44 8","pages":"Page 523"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.repc.2024.12.008
Alicia Prieto-Lobato , Víctor Hidalgo Olivares , Manuel Gerónimo Pardo , Marta Cubells Pastor , Francisco Manuel Salmerón Martínez , Miguel José Corbí-Pascual
Introduction and objectives
Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide, with a prevalence of up to 21% in the early phase of acute myocardial infarction (AMI). Data on new-onset AF in this context are limited, and long-term prognosis remains unclear.
Methods
We conducted a retrospective observational cohort study from December 2011 to May 2021, including patients who experienced a first episode of paroxysmal AF during hospitalization for AMI. The primary outcome was the recurrence of AF within the first year post-discharge. Secondary outcomes included all-cause mortality, cardiovascular mortality, and a composite of major adverse cardiovascular events.
Results
A total of 209 patients were included. There was AF recurrence in 19 patients, 9.1% (95% CI 5.2–13.0%) with a median time to recurrence of 84 days (interquartile range 27.5–157.5). While mortality in the AF recurrence group was numerically higher than in the non-AF recurrence group, this difference did not achieve statistical significance (15.8% vs. 7.4%, p=0.19). Patients with AF recurrence had significantly worse prognosis (47.4% vs. 23.7%, p=0.04), primarily due to increased heart failure (HF) hospitalizations.
Conclusions
In patients with a first episode of paroxysmal AF during AMI, one-year recurrence is relatively low (9.1%); however, AF recurrence is associated with significantly worse prognosis, driven largely by HF hospitalizations.
简介和目的：心房颤动（AF）是世界范围内最常见的心律失常，在急性心肌梗死（AMI）早期的患病率高达21%。在这种情况下，新发房颤的数据有限，长期预后仍不清楚。方法：我们从2011年12月至2021年5月进行了一项回顾性观察队列研究，包括因AMI住院期间首次发作阵发性房颤的患者。主要终点是房颤在出院后一年内的复发率。次要结局包括全因死亡率、心血管死亡率和主要心血管不良事件的组合。结果：共纳入209例患者。19例患者房颤复发，9.1% (95% CI 5.2-13.0%)，中位复发时间为84天[四分位数间距27.5-157.5]。虽然房颤复发组的死亡率在数字上高于非房颤复发组，但这种差异没有统计学意义（15.8% vs. 7.4%, p=0.19）。房颤复发患者的预后明显较差（47.4%对23.7%,p=0.04），主要是由于心力衰竭（HF）住院次数增加。结论：AMI期间首发发作阵发性房颤的患者，1年复发率相对较低（9.1%）；然而;房颤复发与明显较差的预后相关，主要由心衰住院所致。
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