Search

The increased use of the Automated External Defibrillator (AED) and the creation of cardio protected areas in the world and in Mexico contribute to increased survival rates after Out of Hospital Cardiac Arrest (OHCA). When used, the AED records not only the heart rhythm, but also information about Cardiopulmonary Resuscitation (CPR) in the unconscious victim. This data could be important and useful for further diagnosis and treatment. However, there are also some legal questions regarding the use of this information and how it should be managed. To this purpose we suggest the creation of a National Registry of Out-of-Hospital Cardiac Arrest (RENAPACE, for its acronym in Spanish) to handle the AED data. That information could serve for several purposes: 1. Guarantee the availability of data in Mexico for the care of patients who survive an episode of OHCA. 2. To monitor the quality in the use of the AED. 3. Scientific research. 4. To help create a more concise registry of the cause of death and push to include the term «sudden cardiac death» in death certificates. Creating a national AED registry requires, medical and political will and could confront economical, political, legal and organizational problems to address. There are some cities in Mexico developing this program. [ABSTRACT FROM AUTHOR]

Sudden cardiac death is a common occurrence. Out-of-hospital cardiac arrest is a global public health problem suffered by ≈3.8 million people annually. Progress has been made in the knowledge of this disease, its prevention, and treatment; however, most events occur in people without a previous diagnosis of heart disease. Due to its multifactorial and complex nature, it represents a challenge in public health, so it led us to work in a consensus to achieve the implementation of cardioprotected areas in Mexico as a priority mechanism to treat these events. Public access cardiopulmonary resuscitation (CPR) and early defibrillation require training of non-medical personnel, who are usually the first responders in the chain of survival. They should be able to establish a basic and efficient CPR and use of the automatic external defibrillator (AED) until the emergency services arrive at the scene of the incident. Some of the current problems in Mexico and alternative solutions for them are addressed in the present work. [ABSTRACT FROM AUTHOR]

Copyright of Cardiovascular & Metabolic Science is the property of Cardiovascular & Metabolic Science, Asociacion Nacional de Cardiologos de Mexico A.C. (ANCAM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardiovascular & Metabolic Science is the property of Cardiovascular & Metabolic Science, Asociacion Nacional de Cardiologos de Mexico A.C. (ANCAM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Atrial fibrillation (AF) is the most prevalent arrhythmia and is related to significant morbidity, mortality and costs. In spite of relevant advances in the prevention of embolic events and rhythm control, little has been done to reduce its prevalence, progression and impact since it increases with aging as well as with common risk factors such as alcohol intake, tobacco use and stress as well as with arterial hypertension, diabetes mellitus, heart failure, sleep apnea, kidney failure, chronic pulmonary obstructive disease, ischemic heart disease and stroke, among other important comorbidities. Fortunately, new evidence suggests that lifestyle modifications and adequate risk factors and comorbidities control could be effective in primary and secondary AF prevention, especially in its paroxysmal forms. This is why a multidisciplinary approach integrating lifestyle modifications, risk factors and comorbidities control is necessary for conjunction with rhythm or rate control and anticoagulation. Unfortunately, that holistic approach strategy is not considered, is scarcely studied or is subtilized in general clinical practice. The present statement's objectives are to: a) Review the relationship between habits, risk factors and illnesses with AF, b) Review the individual and common physiopathology mechanisms of each one of those conditions that may lead to AF, c) Review the effect of control of habits, risk factors and co-morbidities on the control and impact of AF, d) Supply guidelines and recommendations to start multidisciplinary and integrative AF treatment. [ABSTRACT FROM AUTHOR]

The number of air travelers has increased over the past years, and after the limitations imposed by the COVID-19 pandemic, are expected to increase further. Given these conditions, the possibility for a health professional to find himself needing to assist an in-flight cardiac arrest is also increased. The present work describes some of the most common problems in managing an inflight cardiac arrest and emphasizes the relevance of cardiopulmonary resuscitation (CPR) performance and automated external defibrillators (AED) use on board of commercial airliners. [ABSTRACT FROM AUTHOR]

Copyright of Cardiovascular & Metabolic Science is the property of Cardiovascular & Metabolic Science, Asociacion Nacional de Cardiologos de Mexico A.C. (ANCAM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Atrial fibrillation (AF) is a chronic degenerative and multifactorial disease with increasing prevalence and incidence that might even reach epidemic proportion, as with obesity. A highly prevalent problem worldwide. The combination of both conditions represents higher morbidity and mortality risks, and obesity is a risk factor for AF and worse outcomes of this complex arrhythmia. In the present work, we review the pathophysiological interactions between obesity and AF, the beneficial effects of obesity control on AF outcomes and the potentiation of better results with the current treatments for AF. [ABSTRACT FROM AUTHOR]

Objetive. Out-of-hospital cardiac arrest (OCHA) is a public health problem in which survival depends on community initial response among others. This study tries to analyze what's the proportional cost of enhancing such response by involving the police corps in it. Materials and Methods. We analyzed retrospectively an OCHA registry started on June 2009. We contrasted a model with limited number of ambulances and police based irst response. Results. Mortality was 100%, response times high and 10.8% of the victims were receiving cardiopulmonary resuscitation (CPR) by bystanders. In 63.7% of the events the police arrived before the ambulance, in 1.5% of these cases the police provided CPR. The cost for each saved life was of 5.8-60 million Mexican pesos per life with only ambulance model vs 0.5-5.5 million Mexican pesos on a police first response model with 12 ambulances. Conclusions. In Queretaro interventions can be performed taking advantage of the response capacity of the existing police focused on diminishing mortality from OCHA at a lesser cost than delegating this function only to ambulances. [ABSTRACT FROM AUTHOR]

Syncope is a common symptom among older adults. Its aetiologic diagnosis is mainly clinical, but when it has an unknown origin, complementary studies are necessary. We present the experience of a single center in diagnosing Unknown Origin Syncope (UOS). Methods: We performed a transversal retrolective study to assess the different tests done to patients studied because of USO. Results: The mean age of the older group was 77.6±6.9 years. The 24-hour Holter were abnormal in 77.9% of patients, but diagnostic in only 16.3%. Age older than 65 years was associated with a 1.9 increase (CI 95% 0.9 - 4) in the possibilities of having a diagnosis, while age lesser than 65 was associated with a 0.5 risk IC 95% 0.2 - 1.08 of having a diagnosis. The 48-hour holter showed similar results. Older age was associated with a 1.69 OR, CI 95% 0.6 - 4.4 to have a positive Tilt test (91% of older patients). They had mainly the vasodepressor variety of neurally-mediated syncope. (57.1% Vs 40.1%, p=0.01). Of the 6 electrophysiologic studies performed in people older than 65 years, 3 where diagnostic (50% Vs 33.3%, p=0.6).Conclusions: Complimentary tests in people elder than 65 years are diagnostic in a higher proportion than in their younger counterparts. Nevertheless there is a higher risk of false-positive results, so tests such as head-up tilt test should be more carefully interpreted. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most prevalent arrhythmia and is related with significant morbidity, mortality and costs. In spite of relevant advances in the prevention of embolic events and rhythm control, little has been done to reduce its prevalence, progression and impact, since it increases with ageing as well as with common risk factors such as alcohol intake, tobacco use and stress as well as with arterial hypertension, diabetes mellitus, heart failure, sleep apnea, kidney failure, chronic pulmonary obstructive disease, ischemic heart disease and stroke, among other important comorbidities. Fortunately, new evidence suggests that lifestyle modifications and adequate risk factors and comorbidities control could be effective in primary and secondary AF prevention, especially in its paroxysmal presentations. This is why a multidisciplinary approach integrating lifestyle modifications, risk factors and comorbidities control, is necessary in conjunction with rhythm or rate control and anticoagulation. Unfortunately, that holistic approach strategy is not considered, is scarcely studied or is subtilized in general clinical practice. The present statement's objectives are to: 1) review the relationship between habits, risk factors and illnesses with AF, 2) review the individual and common physiopathology mechanisms of each one of those conditions that may lead to AF, 3) review the effect of control of habits, risk factors and co-morbidities on the control and impact of AF, and 4) supply guidelines and recommendations to start multidisciplinary and integrative AF treatment.

Sudden cardiac death is a common occurrence. Out-of-hospital cardiac arrest is a global public health problem suffered by ≈3.8 million people annually. Progress has been made in the knowledge of this disease, its prevention, and treatment; however, most events occur in people without a previous diagnosis of heart disease. Due to its multifactorial and complex nature, it represents a challenge in public health, so it led us to work in a consensus to achieve the implementation of cardioprotected areas in Mexico as a priority mechanism to treat these events. Public access cardiopulmonary resuscitation (CPR) and early defibrillation require training of non-medical personnel, who are usually the first responders in the chain of survival. They should be able to establish a basic and efficient CPR and use of the automatic external defibrillator (AED) until the emergency services arrive at the scene of the incident. Some of the current problems in Mexico and alternative solutions for them are addressed in the present work.

La pandemia de COVID-19 ha infligido grandes estragos a la población y en especial al personal de salud. Los esfuerzos de reanimación exigen modificaciones potenciales de las guías internacionales existentes de reanimación cardiopulmonar (RCP) debido al elevado índice de contagiosidad del virus SARS-CoV-2. Se considera que hasta 15% de los casos de COVID-19 tiene una enfermedad grave y 5% padece un trastorno crítico con una mortalidad promedio del 3%, la cual varía según sean el país y las características de los pacientes. La edad y las comorbilidades como la hipertensión arterial, enfermedad cardiovascular, obesidad y diabetes incrementan la mortalidad hasta 24%. También se ha informado un aumento reciente del número de casos de paro cardíaco extrahospitalario (PCEH). Aunque el paro cardíaco (PC) puede ser efecto de factores diversos en estos pacientes, en la mayoría de los casos se ha demostrado que el origen es respiratorio, con muy pocos casos de causa cardíaca. Se debe considerar la indicación de iniciar o continuar las maniobras de RCP por dos razones fundamentales: la posibilidad de sobrevida de las víctimas, que hasta la fecha se ha registrado muy baja, y el riesgo de contagiar al personal de salud, que es muy alto., The COVID-19 pandemic is having a large impact on the general population, but it has taken a specially high toll on healthcare personnel. Resuscitation efforts require potential modifications of the present Cardiopulmonary Resuscitation (CPR) international guidelines because of the transmissibility rate of the new SARS-CoV 2 virus. It has been seen that up to 15% of COVID-19 patients have a severe disease, 5% have a critical form of infection and the mean death rate is 3%, although there are significant differences according to the country that reports it and patients’ baseline conditions that include age, presence of arterial hypertension, cardiovascular disease, diabetes or obesity. In these high risk subjects, mortality might go up to 24%. There are also reports of a recent increase in out-of-hospital cardiopulmonary arrest (OHCA) victims. Cardiac arrest (CA) in these subjects might be related to many causes, but apparently, that phenomenon is related to respiratory diseases rather than cardiac issues. In this context, the decision to start or continue CPR maneuvers has to be carefully assessed, because of the low survival rate reported so far and the high contagion risk among healthcare personnel., (Copyright: © 2021 Permanyer.)

Knowing the real impact of atrial fibrillation in the stroke, the Sociedad Mexicana of Electrofisiología y Estimulación Cardiaca (SOMEEC) had the initiative to develop a multidisciplinary meeting of experts the with the purpose to update the available scientific evidence from clinical practice guidelines, meta-analyses, controlled clinical trials, and complementing with the experience and views of a group of experts. To meet this goal, SOMEEC gathered a group of specialists in the area of cardiology, electrophysiology, neurology and hematology that given their experience in certain areas, they share the scientific evidence with the panel of experts to leave open a discussion about the information presented in this article. This document brings together the best scientific evidence available and aims to be a useful tool in the decision to use of new oral anticoagulants in nonvalvular atrial fibrillation and ischemic heart disease, or relating to the management of patients with stroke or renal failure, and even those that will be submitted to elective surgery and invasive procedures. In the same, they handled comparative schemes of follow-up and treatment which simplifies the decision making by the specialists participants., (Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.)

We present a 56 years-old male patient with an acute ischemic episode. The patient showed significant dilation of the left main coronary artery and proximal segments of the left descending artery, as well as a right coronary artery with a 10mm diameter in the proximal and medial segments. These findings are compatible with a Kawasaki's disease in a chronic phase., (Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.)

In Mexico, out-of-hospital cardiac arrest is a health problem that represents 33,000 to 150,000 or more deaths per year. The few existent reports show mortality as high as 100% in contrast to some international reports that show higher survival rates. In Queretaro, during the last 5 years there were no successful resuscitation cases. However, in 2012 some patients were reported to have return of spontaneous circulation. We report in this article 3 cases with return of spontaneous circulation and pulse at arrival to the hospital. Two of the patients were discharged alive, one of them with poor cerebral performance category. Community cardiopulmonary resuscitation, early defibrillation and better emergency medical system response times, are related with survival. This poorly explored health problem in Queretaro could be increased with quality and good public education, bystander assisted cardiopulmonary resuscitation, police involvement in cardiopulmonary resuscitation and defibrillation, public access defibrillation programs and measurement of indicators and feedback for better results., (Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.)