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[PMID]:29289261
[Au] Autor:Yu M; Chen T; Hu S; Zou S; Wang C; Zeng C; Chen W; Tan X
[Ad] Endereço:Department of Cardiology, The First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.
[Ti] Título:R-Wave Peak Time at Lead II in Adults With Ventricular Premature Beats, Bundle Branch Block and Left Anterior Fascicular Block.
[So] Source:Am J Med Sci;355(1):44-47, 2018 01.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Recently, the R-wave peak time (RWPT) at lead II was reported to be a helpful and simple tool for differentiating wide QRS complex tachycardias with a RWPT ≥ 50ms for ventricular tachycardia diagnosis. Our previous study showed that the duration of RWPT at lead II in adults was ≈29ms. However, the effects of ventricular premature beats (VPBs), bundle branch block (BBB) or left anterior fascicular block (LAFB) on RWPT at lead II remain unknown. METHODS: The study was conducted in the First Affiliated Hospital of Shantou University Medical College in Southern China. Adults with VPBs, BBB or LAFB were included. RWPT at lead II was determined. RESULTS: Compared with the control groups, the right BBB, LAFB, RWPT were longer in groups with left BBB and VPBs. Compared with the group with left BBB, the group with VPBs had a significantly longer RWPT at lead II (54.20 ± 18.52 versus 84.76 ± 16.38ms, P < 0.01). CONCLUSION: Our study showed that there is a significant difference in the RWPT at lead II between groups with left BBB, ventricular premature beat, right BBB and LAFB. A RWPT of 50ms may be optimal to differentiate between ventricular tachycardia and supraventricular tachycardia with right left BBB and LAFB, but not with left BBB.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico
Bloqueio de Ramo/fisiopatologia
Taquicardia Ventricular/diagnóstico
Taquicardia Ventricular/fisiopatologia
Complexos Ventriculares Prematuros/diagnóstico
Complexos Ventriculares Prematuros/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Bloqueio de Ramo/epidemiologia
Eletrocardiografia/métodos
Feminino
Seres Humanos
Masculino
Taquicardia Ventricular/epidemiologia
Fatores de Tempo
Complexos Ventriculares Prematuros/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180101
[St] Status:MEDLINE


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[PMID]:29381953
[Au] Autor:Liu X; Zheng J; Fan Z; Rao L
[Ad] Endereço:Department of Cardiovascular Medicine, West China Hospital, Sichuan University, Chengdu.
[Ti] Título:Case report: an unusual case of Brugada syndrome combined with a ventricular septal defect: A case report.
[So] Source:Medicine (Baltimore);96(47):e8695, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Brugada syndrome (BrS) is a cardiac ion channel disease that is caused by an autosomal dominant genetic abnormality. A ventricular septal defect is a common congenital heart disease, in which genetic defects play a significant role. PATIENT CONCERNS: We report an extremely rare case of a 42-year-old male with congenital heart disease, who suffered recurrent syncope and gastrointestinal bleeding. His electrocardiogram showed an unusual right bundle branch block-like pattern and ST-segment elevation in leads V1-V3. DIAGNOSES: The patient was eventually diagnosed with Brugada Syndrome Combined with a Ventricular Septal Defect. INTERVENTIONS: The patient was treated with ICD implants. OUTCOMES: We extracted his blood and performed whole exome sequencing. Whole exome sequencing revealed mutations in genes, which encode ion channels and proteins important for embryonic heart development. However, a novel mutation in the SCN5A gene was also found. LESSONS: To our knowledge, this is the first genetically proven case of BrS combined with a ventricular septal defect.
[Mh] Termos MeSH primário: Síndrome de Brugada/complicações
Comunicação Interventricular/complicações
[Mh] Termos MeSH secundário: Adulto
Síndrome de Brugada/genética
Bloqueio de Ramo/patologia
Eletrocardiografia
Comunicação Interventricular/genética
Seres Humanos
Masculino
Sequenciamento Completo do Exoma
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008695


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[PMID]:29304097
[Au] Autor:Fayssoil A; Ben Yaou R; Ogna A; Chaffaut C; Leturcq F; Nardi O; Wahbi K; Duboc D; Lofaso F; Prigent H; Clair B; Crenn P; Nicolas G; Laforet P; Behin A; Chevret S; Orlikowski D; Annane D
[Ad] Endereço:Service de Réanimation médicale et unité de ventilation à domicile, CHU Raymond Poincaré, APHP, Université de Versailles Saint Quentin en Yvelines, Garches, France.
[Ti] Título:Left bundle branch block in Duchenne muscular dystrophy: Prevalence, genetic relationship and prognosis.
[So] Source:PLoS One;13(1):e0190518, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Duchenne muscular dystrophy (DMD) is an inherited myogenic disorder due to mutations in the dystrophin gene on chromosome Xp21.1. We designed this study to determine the prevalence of left bundle branch block (LBBB), whether there is a relationship between LBBB and genetic pattern, and to assess predictive factors for acute cardiac events and mortality in adult DMD patients. METHODS: We reviewed the charts of DMD followed at the Home Mechanical Ventilation Unit of the Raymond Poincare University Hospital. RESULTS: A total of 121 patients, aged from 18 to 41 years have been included in our study. Median vital capacity (VC) was 12% [7; 19.5] of predicted. Almost all patients were on home mechanical ventilation (95%). LBBB was present in 15 patients (13%); among them, 10 disclosed exonic deletions. After a median follow up of 6 years, 21 patients (17%) experienced acute heart failure (AHF), 7 patients (6%) supraventricular arrhythmia, 3 patients (2.4%) ventricular tachycardia, 4 patients (3%) significant electrical disturbances. LBBB was significantly associated with cardiac events (OR = 12.7; 95%CI [3.78-42.7]; p <0.0001) and mortality (OR = 4.4; 95%CI [1.44-13.7]; p 0.009). Presence of residual dystrophin protein was not associated with significant less cardiac events. Age and LVEF were also predictive factors for cardiac events and mortality. CONCLUSION: LBBB is relatively frequent in DMD and is a major predictive factor for cardiac events and mortality. Presence of residual dystrophin protein was not associated with a lower incidence of cardiac events.
[Mh] Termos MeSH primário: Bloqueio de Ramo/fisiopatologia
Predisposição Genética para Doença
Distrofia Muscular de Duchenne/complicações
[Mh] Termos MeSH secundário: Adulto
Bloqueio de Ramo/epidemiologia
Bloqueio de Ramo/etiologia
Bloqueio de Ramo/genética
Feminino
Seres Humanos
Masculino
Prevalência
Prognóstico
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190518


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[PMID]:29327898
[Au] Autor:Krca B; Dzudovic B; Vukotic S; Ratkovic N; Subotic B; Vranes D; Rusovic S; Obradovic S
[Ti] Título:Association of different electrocardiographic patterns with shock index, right ventricle systolic pressure and diameter, and embolic burden score in pulmonary embolism.
[So] Source:Vojnosanit Pregl;73(10):921-6, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Some electrocardiographic (ECG) patterns are characteristic for pulmonary embolism but exact meaning of the different ECG signs are not well known. The aim of this study was to determine the association between four common ECG signs in pulmonary embolism [complete or incomplete right bundle branch block (RBBB), S-waves in the aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads] with shock index (SI), right ventricle diastolic diameter (RVDD) and peak systolic pressure (RVSP) and embolic burden score (EBS). Methods: The presence of complete or incomplete RBBB, S waves in aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads were determined at admission ECG in 130 consecutive patients admitted to the intensive care unit of a single tertiary medical center in a 5-year period. Echocardiography examination with measurement of RVDD and RVSP, multidetector computed tomography pulmonary angiography (MDCT-PA) with the calculation of EBS and SI was determined during the admission process. Multivariable regression models were calculated with ECG parameters as independent variables and the mentioned ultrasound, MDCT-PA parameters and SI as dependent variables. Results: The presence of S-waves in the aVL was the only independent predictor of RVDD (F = 39.430, p < 0.001; adjusted R2 = 0.231) and systolic peak right ventricle pressure (F = 29.903, p < 0.001; adjusted R2 = 0.185). Negative T-waves in precordial leads were the only independent predictor for EBS (F = 24.177, p < 0.001; R2 = 0.160). Complete or incomplete RBBB was the independent predictor of SI (F = 20.980, p < 0.001; adjusted R2 = 0.134). Conclusion: In patients with pulmonary embolism different ECG patterns at admission correlate with different clinical, ultrasound and MDCT-PA parameters. RBBB is associated with shock, Swave in the aVL is associated with right ventricle pressure and negative T-waves with the thrombus burden in the pulmonary tree.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico
Eletrocardiografia
Frequência Cardíaca
Embolia Pulmonar/diagnóstico
Choque/diagnóstico
Função Ventricular Direita
Pressão Ventricular
[Mh] Termos MeSH secundário: Adulto
Idoso
Bloqueio de Ramo/etiologia
Bloqueio de Ramo/fisiopatologia
Angiografia por Tomografia Computadorizada
Ecocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada Multidetectores
Análise Multivariada
Valor Preditivo dos Testes
Embolia Pulmonar/etiologia
Embolia Pulmonar/fisiopatologia
Análise de Regressão
Fatores de Risco
Índice de Gravidade de Doença
Choque/etiologia
Choque/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150512011K


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[PMID]:29202532
[Au] Autor:Di CY; Wan Z; Li K; Ding YS; Lin WH
[Ti] Título:[Premature outflow tract ventricular contraction combined with complete bundle branch block: the characteristic electrocardiographic and ablation target potential features].
[So] Source:Zhonghua Nei Ke Za Zhi;56(12):919-923, 2017 Dec 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the characteristics of electrocardiogram(ECG) and target potential features of premature ventricular contraction (PVC) in patients with complete left/right bundle branch block (CL/RBBB) and compare with those without CL/RBBB. A retrospective analysis was done in 8 outflow tract PVC patients with CL/RBBB, who successfully underwent radiofrequency ablation from August 2009 to June 2017. According to the bundle branch block chamber, patients were divided into the complete right bundle branch block (CRBBB) group ( 4) and the complete left bundle branch block (CLBBB) group ( 4). The control group were those who successfully underwent ablation at the same position as the above two groups but without CL/RBBB. The characteristics of ECG and target potential features were compared among groups. One case in the CRBBB group was successfully ablated in the great cardiac vein with precordial R/S>1 transition at V(1) and one case in the CLBBB group was successfully ablated in the right coronary cusp with precordial R/S>1 transition at V(2), while other 6 cases were all with precordial R/S>1 transition at lead V(4). Precordial R/S>1 transition was not later than sinus rhythm (SR) in the CLBBB group. No statistical difference was found in the QRS complex duration between SR and PVC in the CL/RBBB patients [(134.38±23.80)ms vs (156.75±25.93)ms, 0.05], while statistical difference was shown in the control group [(92.63±5.76)ms vs (140.25±15.97)ms, 0.05]. Bundle branch block can lead to misjudgment of PVC origin with CL/RBBB during sinus rhythm, thus the origin chamber of the PVC should be determined according to the mapping and ablation result.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico
Bloqueio de Ramo/cirurgia
Complexos Ventriculares Prematuros/diagnóstico
Complexos Ventriculares Prematuros/cirurgia
[Mh] Termos MeSH secundário: Ablação por Cateter/métodos
Eletrocardiografia
Técnicas Eletrofisiológicas Cardíacas
Feminino
Ventrículos do Coração
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2017.12.006


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[PMID]:29173611
[Au] Autor:Huang W; Su L; Wu S; Xu L; Xiao F; Zhou X; Ellenbogen KA
[Ad] Endereço:Department of Cardiology, First Affiliated Hospital of Wenzhou Medical University, Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, China. Electronic address: weijianhuang69@126.com.
[Ti] Título:A Novel Pacing Strategy With Low and Stable Output: Pacing the Left Bundle Branch Immediately Beyond the Conduction Block.
[So] Source:Can J Cardiol;33(12):1736.e1-1736.e3, 2017 Dec.
[Is] ISSN:1916-7075
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This report demonstrates the feasibility of pacing the left bundle branch (LBB) immediately beyond the conduction block to functionally restore the impaired His-Purkinje conduction system in a patient with heart failure and left bundle branch block (LBBB). The pacing required only a low pacing output (0.5 volts/0.5 ms) to correct the LBBB with accompanying right BBB on the electrocardiogram. Over 1-year of follow-up, the patient had a significant improvement in clinical outcome and echocardiographic measurements. The case shows a novel pacing strategy for patients with BBB that affects many patients with heart failure.
[Mh] Termos MeSH primário: Fascículo Atrioventricular/fisiopatologia
Bloqueio de Ramo/terapia
Débito Cardíaco/fisiologia
Estimulação Cardíaca Artificial/métodos
Ventrículos do Coração/fisiopatologia
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Idoso
Bloqueio de Ramo/fisiopatologia
Ecocardiografia
Eletrocardiografia
Feminino
Seguimentos
Ventrículos do Coração/diagnóstico por imagem
Seres Humanos
Volume Sistólico/fisiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:29049164
[Au] Autor:Li Q; Wang DZ; Chen BX
[Ad] Endereço:Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Electrocardiogram in patients with acute inferior myocardial infarction due to occlusion of circumflex artery.
[So] Source:Medicine (Baltimore);96(42):e6095, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To investigate the diagnostic value of electrocardiographic (ECG) ST-segment in acute inferior myocardial infarction (AIMI) caused by the left circumflex branch (LCX).A total of 240 clinical cases with AIMI in our hospital were retrospectively analyzed. All of them had received percutaneous coronary intervention (PCI) within 12 hours after symptom onset. The clinical features, ECG manifestations, and coronary artery lesion characteristics of the patients were collected.The right coronary artery (RCA) was shown to be the infarct-related artery (IRA) in 177 patients, while LCX was responsible for AIMI in 63 cases. There was no significant difference in the risk factors of coronary heart disease (CHD) (P > .05 for all) between the 2 groups. ST-segment elevation in lead II, III, and AVF could be found in all patients. Moreover, ST-segment depression in lead I (STD I), ST-segment elevation in lead III (STE III), STE III-STE II, STE AVF, STD AVL, STD AVL-STD I and STE v6 lead ST-segment deviation exhibited significant difference in 2 groups (P < .05 for all). The changes of STD I, STE III < STEII, STD AVL < STD I could discriminate between LCX and RCA in AIMI patients with high sensitivity and specificity.ECG may be an effective tool to predict the IRA in patient with AIMI.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico por imagem
Oclusão Coronária/diagnóstico por imagem
Eletrocardiografia/métodos
Infarto Miocárdico de Parede Inferior/diagnóstico por imagem
Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Síndrome de Brugada/complicações
Síndrome de Brugada/diagnóstico por imagem
Bloqueio de Ramo/complicações
Doença do Sistema de Condução Cardíaco
Doença das Coronárias/complicações
Doença das Coronárias/diagnóstico por imagem
Oclusão Coronária/complicações
Vasos Coronários/diagnóstico por imagem
Feminino
Sistema de Condução Cardíaco/diagnóstico por imagem
Seres Humanos
Infarto Miocárdico de Parede Inferior/etiologia
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Retrospectivos
Fatores de Risco
Infarto do Miocárdio com Supradesnível do Segmento ST/etiologia
Sensibilidade e Especificidade
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006095


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[PMID]:28899954
[Au] Autor:Michowitz Y; Tovia-Brodie O; Heusler I; Sabbag A; Rahkovich M; Shmueli H; Glick A; Belhassen B
[Ad] Endereço:From the Department of Cardiology, Tel Aviv Sourasky Medical Center, Israel (Y.M., O.T.-B., I.H., M.R., H.S., A.G., B.B.); Department of Cardiology, Sheba Medical Center, Israel (A.S.); and Department of Cardiology, Sackler Faculty of Medicine, Tel Aviv University, Israel (Y.M., O.T.-B., I.H., A.S.,
[Ti] Título:Differentiating the QRS Morphology of Posterior Fascicular Ventricular Tachycardia From Right Bundle Branch Block and Left Anterior Hemiblock Aberrancy.
[So] Source:Circ Arrhythm Electrophysiol;10(9), 2017 Sep.
[Is] ISSN:1941-3084
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Left posterior fascicular ventricular tachycardia (LPF-VT) is frequently misdiagnosed as supraventricular tachycardia with aberrant right bundle branch block (RBBB) and left anterior hemiblock (LAHB). The purpose of the present study was to define the morphological ECG characteristics of LPF-VT and attempt to differentiate it from RBBB and LAHB aberrancy. METHODS AND RESULTS: A systematic Medline search was used to identify or locate ECG tracings from patients with LPF-VTs. ECGs with LPF-VT were also collected from patients who underwent ablation of this arrhythmia at the Tel Aviv and Sheba Medical Centers. These ECGs were compared with ECGs of consecutive patients with RBBB and LAHB and no obvious cardiac pathology by echocardiography. Overall, 183 ECGs of LPF-VT were compared with 61 ECGs showing RBBB and LAHB. Univariate analysis demonstrated differences in QRS axis, limb (I, aVr), and precordial (V , V , V ) ECG leads. On multivariate logistic regression analysis, LPF-VT was more often associated with atypical RBBB-like V morphology (odds ratio, 5.1; =0.004), positive QRS in aVr (odds ratio, 19.2; <0.001), V R/S ratio ≤1 (odds ratio, 6.7; =0.01), and QRS ≤140 ms (odds ratio, 7.7; <0.001). Using these 4 variables, a prediction model was developed that predicted LPF-VT with sensitivity and specificity of 82.1% and 78.3%, respectively. Patients with 3 of 4 positive variables had high probability of having LPF-VT, whereas patients with ≤1 positive variable always had RBBB plus LAHB. CONCLUSIONS: The morphological ECG characteristics of LPF-VT were defined, and a high accurate tool for correctly differentiating LPF-VT from RBBB and LAHB aberrancy was developed.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico
Eletrocardiografia
Taquicardia Ventricular/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Bloqueio de Ramo/fisiopatologia
Ablação por Cateter
Diagnóstico Diferencial
Ecocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Taquicardia Ventricular/fisiopatologia
Taquicardia Ventricular/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE


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[PMID]:28893961
[Au] Autor:Auffret V; Puri R; Urena M; Chamandi C; Rodriguez-Gabella T; Philippon F; Rodés-Cabau J
[Ad] Endereço:From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R
[Ti] Título:Conduction Disturbances After Transcatheter Aortic Valve Replacement: Current Status and Future Perspectives.
[So] Source:Circulation;136(11):1049-1069, 2017 Sep 12.
[Is] ISSN:1524-4539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Transcatheter aortic valve replacement (TAVR) has become a well-accepted option for treating patients with aortic stenosis at intermediate to high or prohibitive surgical risk. TAVR-related conduction disturbances, mainly new-onset left bundle-branch block and advanced atrioventricular block requiring permanent pacemaker implantation, remain the most common complication of this procedure. Furthermore, improvements in TAVR technology, akin to the increasing experience of operators/centers, have translated to a major reduction in periprocedural complications, yet the incidence of conduction disturbances has remained relatively high, with perhaps an increasing trend over time. Several factors have been associated with a heightened risk of conduction disturbances and permanent pacemaker implantation after TAVR, with prior right bundle-branch block and transcatheter valve type and implantation depth being the most commonly reported. New-onset left bundle-branch block and the need for permanent pacemaker implantation may have a significant detrimental association with patients' prognosis. Consequently, strategies intended to reduce the risk and to improve the management of such complications are of paramount importance, particularly in an era when TAVR expansion toward treating lower-risk patients is considered inevitable. In this article, we review the available evidence on the incidence, predictive factors, and clinical association of conduction disturbances after TAVR and propose a strategy for the management of these complications.
[Mh] Termos MeSH primário: Estenose da Valva Aórtica/cirurgia
Arritmias Cardíacas/diagnóstico
Arritmias Cardíacas/etiologia
Bloqueio de Ramo/diagnóstico
Bloqueio de Ramo/etiologia
Substituição da Valva Aórtica Transcateter/efeitos adversos
[Mh] Termos MeSH secundário: Estenose da Valva Aórtica/mortalidade
Arritmias Cardíacas/mortalidade
Bloqueio de Ramo/mortalidade
Previsões
Seres Humanos
Mortalidade/tendências
Substituição da Valva Aórtica Transcateter/mortalidade
Substituição da Valva Aórtica Transcateter/tendências
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1161/CIRCULATIONAHA.117.028352


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[PMID]:28877886
[Au] Autor:Janousek J; Kovanda J; Lozek M; Tomek V; Vojtovic P; Gebauer R; Kubus P; Krejcír M; Lumens J; Delhaas T; Prinzen F
[Ad] Endereço:From the Children's Heart Center, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic (J.J., J.K., M.L., V.T., P.V., R.G., P.K., M.K.); and CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, The Netherlands (J.L., T
[Ti] Título:Pulmonary Right Ventricular Resynchronization in Congenital Heart Disease: Acute Improvement in Right Ventricular Mechanics and Contraction Efficiency.
[So] Source:Circ Cardiovasc Imaging;10(9), 2017 Sep.
[Is] ISSN:1942-0080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Electromechanical discoordination may contribute to long-term pulmonary right ventricular (RV) dysfunction in patients after surgery for congenital heart disease. We sought to evaluate changes in RV function after temporary RV cardiac resynchronization therapy. METHODS AND RESULTS: Twenty-five patients aged median 12.0 years after repair of tetralogy of Fallot and similar lesions were studied echocardiographically (n=23) and by cardiac catheterization (n=5) after primary repair (n=4) or after surgical RV revalvulation for significant pulmonary regurgitation (n=21). Temporary RV cardiac resynchronization therapy was applied in the presence of complete right bundle branch block by atrial-synchronized RV free wall pacing in complete fusion with spontaneous ventricular depolarization using temporary electrodes. The q-RV interval at the RV free wall pacing site (mean 77.2% of baseline QRS duration) confirmed pacing from a late activated RV area. RV cardiac resynchronization therapy carried significant decrease in QRS duration ( <0.001) along with elimination of the right bundle branch block QRS morphology, increase in RV filling time ( =0.002), pulmonary artery velocity time integral ( =0.006), and RV maximum +dP/dt ( <0.001), and decrease in RV index of myocardial performance ( =0.006). RV mechanical synchrony improved: septal-to-lateral RV mechanical delay decreased ( <0.001) and signs of RV dyssynchrony pattern were significantly abolished. RV systolic stretch fraction reflecting the ratio of myocardial stretching and contraction during systole diminished ( =0.001). CONCLUSIONS: In patients with congenital heart disease and right bundle branch block, RV cardiac resynchronization therapy carried multiple positive effects on RV mechanics, synchrony, and contraction efficiency.
[Mh] Termos MeSH primário: Bloqueio de Ramo/terapia
Terapia de Ressincronização Cardíaca
Procedimentos Cirúrgicos Cardíacos
Contração Miocárdica
Tetralogia de Fallot/cirurgia
Disfunção Ventricular Direita/etiologia
Função Ventricular Direita
[Mh] Termos MeSH secundário: Adolescente
Fenômenos Biomecânicos
Bloqueio de Ramo/diagnóstico por imagem
Bloqueio de Ramo/etiologia
Bloqueio de Ramo/fisiopatologia
Cateterismo Cardíaco
Criança
Ecocardiografia Doppler de Pulso
Eletrocardiografia
Técnicas Eletrofisiológicas Cardíacas
Feminino
Hemodinâmica
Seres Humanos
Masculino
Recuperação de Função Fisiológica
Tetralogia de Fallot/complicações
Tetralogia de Fallot/diagnóstico por imagem
Tetralogia de Fallot/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Disfunção Ventricular Direita/diagnóstico por imagem
Disfunção Ventricular Direita/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE



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