Archivos Peruanos de cardiologia y cirugia cardiovascular最新文献

An 82-year-old woman, Katz A, with a history of type 2 diabetes mellitus and high blood pressure, was admitted for ischemic stroke complicated by Takotsubo´s syndrome with subsequent readmission for atrial fibrillation after discharge. These three clinical events have criteria to be integrated as a Brain Heart Syndrome, which is a high-risk condition for mortality.

Objective: . To report the results of ventricular tachycardia (VT) catheter ablation in ischemic heart disease (IHD), and to identify risk factors associated with recurrence in a Mexican center.

Materials and methods: . We made a retrospective review of the cases of VT ablation performed in our center from 2015 to 2022. We analyzed the characteristics of the patients and those of the procedures separately and we determined factors associated with recurrence.

Results: . Fifty procedures were performed in 38 patients (84% male; mean age 58.1 years). Acute success rate was 82%, with a 28% of recurrences. Female sex (OR 3.33, IC 95% 1.66-6.68, p=0.006), atrial fibrillation (OR 3.5, IC 95% 2.08-5.9, p=0.012), electrical storm (OR 2.4, IC 95% 1.06-5.41, p=0.045), functional class greater than II (OR 2.86, IC 95% 1.34-6.10, p=0.018) were risk factors for recurrence and the presence of clinical VT at the time of ablation (OR 0.29, IC 95% 0.12-0.70, p=0.004) and the use of more than 2 techniques for mapping (OR 0.64, IC 95% 0.48-0.86, p=0.013) were protective factors.

Conclusions: . Ablation of ventricular tachycardia in ischemic heart disease has had good results in our center. The recurrence is similar to that reported by other authors and there are some factors associated with it.

We report a case of cor triatriatum sinister associated with anomalous pulmonary venous drainage in an adult patient who presented with palpitations, lower limb edema, dyspnea, orthopnea, bendopnea and ascites. The clinical picture began with episodes of atrial fibrillation, associated with rehospitalizations for right heart failure, so angiotomography and transesophageal echography were requested, which led to the final diagnosis. The surgical approach was performed by total excision of the multifenestrating fibromuscular septum and double valvular plasty, due to severe mitral and tricuspid insufficiency, which improved the patient's clinical condition. The importance of considering this acyanotic congenital heart disease within the differential diagnosis of the causes of right heart failure originating in the left atrium is recognized.

Left bundle branch stimulation is a second-line strategy in patients where His bundle stimulation is not optimal. Currently, no cases of left bundle branch stimulation have been reported in patients with diffuse electrical cardiac disease or in the pediatric population.

Objective: To determine the degree of knowledge about warfarin treatment in patients with atrial fibrillation or with mechanical prosthetic valves.

Materials and methods: Descriptive, observational, cross-sectional study. The OAK test was applied to all adult patients with a diagnosis of atrial fibrillation or with mechanical prosthetic valves treated with warfarin, who attended the hematology consultation from May 17 to November 10, 2022, at the "Instituto Nacional Cardiovascular Carlos Alberto Peschiera Carrillo".

Results: A total of 150 patients participated, 64% were male, with a mean age of 60.3 ± 15 years, 45.3% with a diagnosis of atrial fibrillation and 54.7% with mechanical prosthetic valves. The mean OAK test score was 44.4% (8.4/19), only 6% (n=9) achieved a satisfactory score ≥75.0%, the percentage of correct answers according to dimensions was: 68 % in forms of use, 39.3% in interactions and complications and 41.1% in INR control. A 40.7% did not understand the meaning of the term INR and 81.3% did not know their optimal values.

Conclusions: The patient's degree of knowledge about warfarin treatment was inadequate; both in its use, interactions and complications. Considering that it is a difficult drug to use, due to its narrow therapeutic window and its multiple interactions, inadequate knowledge of its use may contribute to inappropriate anticoagulation.